New Test May Replace Pap Smear as Initial Screen

HPV test to detect cervical cancer now recommended in place of Pap smear

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Pap smears may be passé for some women. A new cervical cancer test may be coming into vogue.

A group of cervical cancer screening experts recently released new recommendations for cervical cancer screening. Under these recommendations, doctors would use the human papillomavirus (HPV) test instead of a Pap smear to detect cervical cancer.

Pap smears would be used to confirm cervical cancer in the event of a positive HPV test or for initial screening of women younger than 25. The current practice is to perform only a Pap smear or to perform both a Pap smear and an HPV test.

Warner K. Huh, MD, Director of the University of Alabama at Birmingham Division of Gynecologic Oncology, led the expert panel that issued the new recommendations.

“The scientific evidence clearly demonstrates that primary HPV testing outperforms cytology or Pap as a screening test," Dr. Huh said in a press release. "There are going to be fewer false negatives with HPV, and arguably, we have been using a less sensitive test for screening for a while now.”

Dr. Huh added that “Pap smears miss a fair number of [tumors]. We don’t want a test that will miss disease.”

Pap tests have been in use for 80 years. The HPV test is newer and less likely to have a false negative result — to show no cancer cells when cancer is actually present.

In April of 2014, the US Food and Drug Administration approved an HPV test for primary cervical cancer screening. Professional medical organizations, however, had not yet studied the risks and benefits of changing the recommended screening practices, which were developed in 2011.

These new recommendations note that using HPV screening is as effective as a Pap smear. They also note that the lower risk of false negatives provides extra peace of mind for women who are worried that they may have cervical cancer.

Most women should be screened for cervical cancer — a cancer that begins in the cervix — every three years, Dr. Huh and colleagues wrote. Although doctors may still choose to co-test with a Pap smear and an HPV test, the panel felt that screening only with an HPV test every three years was equally effective and less expensive.

HPV infections — also known as genital warts — are relatively common in young women who are sexually active. Most HPV infections clear up without treatment, but some can cause cervical cancer. Patients can be infected and not know it because no symptoms show. Patients can protect themselves from HPV by using condoms with their partners.

These recommendations were published Jan. 8 in Gynecologic Oncology.

The panel experts disclosed no funding sources. Several panel members received consulting fees or participated in clinical trials sponsored by companies like Merck, Roche and Gen Probe, which make or distribute products used in cervical cancer screening.

Review Date: 
January 8, 2015
Last Updated:
January 11, 2015