DNA-Based HPV Tests More Accurate Than Pap Smears
TUESDAY, March 25 -- A new study confirms previous findings that human papillomavirus (HPV) DNA-based tests are more accurate than Pap smears in detecting precancerous lesions.
It was already known that the HPV test uncovered more infections and precancerous lesions than Pap smears (cytology), but it wasn't clear whether HPV tests would lead to the treatment of patients whose immune systems would fight off infections -- meaning that these women didn't require treatment, anyway.
In this study of almost 50,000 women, Italian researchers found that the HPV test identified almost twice as many premalignant lesions compared to Pap smears. Among women ages 35 to 60, the HPV test was more likely to detect cervical lesions. In women ages 25 to 34, the HPV test seemed to identify more infections that eventually resolved themselves.
Based on their findings, the researchers said it may be best for younger women with a positive HPV test to be retested in 12 months, rather than being immediately referred for a more intensive examination called colposcopy.
"It seems clear that an HPV DNA-based approach to primary screening is a very attractive option that should be actively developed and evaluated," wrote Dr. Guglielmo Ronco, from CPO Piemonte, in Torino, Italy, and colleagues.
The findings of this study, which were published in the Journal of the National Cancer Institute, reinforced similar findings in a study published in 2006 by Ronco and team.
That earlier study of 33,364 women, ages 35 to 60, found that HPV testing combined with liquid-based Pap testing detected 47 percent more precancerous lesions than conventional Pap smears. However, the combination testing increased the chance of false positives by 60 percent.
HPV accounts for almost all cases of cervical cancer.
Posted: March 2008