HPV test 'more effective than cervical smear'

Cancer Research shows HPV DNA test picks up more precancerous cervical cells than conventional cytology.

Cervical cancer: HPV testing ‘should be primary screening method’ (CENTRE JEAN PERRIN, ISM/SPL)
Cervical cancer: HPV testing ‘should be primary screening method’ (CENTRE JEAN PERRIN, ISM/SPL)

HPV screening can detect more precancerous cervical cells than smear tests, research suggests.

Finnish researchers found that HPV DNA tests followed by cytology triage may be more sensitive than conventional cytology in detecting severe precancerous lesions.

Previous research had suggested HPV screening may boost detection of precancerous lesions.

A total of 58,076 women aged 30-60 years were invited for cervical cancer screening. Researchers randomly assigned them to either an HPV DNA test with cytology triage or a smear test.

The researchers looked for incidence of cervical intraepithelial neoplasia (CIN) grade III and adenocarcinoma in situ (CIN III+) as clinical outcomes. Over five years, 129 CIN III+ cases were found, 14 of which were cervical cancers.

Among women invited for screening, the HPV test and subsequent cytology were 44 per cent more likely to detect CIN III+. This rose to 77 per cent among women who attended.

The study authors said the 'high probability of progression of CIN III lesions in women aged 35 and over' meant their results were important for the prevention of cervical cancer.

Meanwhile, a UK study in the British Journal of Cancer found that HPV negative women were less likely to develop precancerous (CIN II+) cells for at least six years compared with women with a negative cytology result.

Study author Professor Jack Cuzick of Queen Mary, University of London said using HPV tests as the primary screening method for cervical cancer would mean women could be screened less often.

  • BMJ Online 2010; Br J Cancer Online 2010

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