HPV tests are better at finding cervical cancer

Human papillomavirus (HPV) testing is more accurate than cervical cytology for the early detection of invasive cervical cancer in older women, according to Danish researchers.

HPV cells
They suggest that it should be added to cervical cytology to improve the cervical screening programme. The study included two cohorts of Danish women, recruited from a national patient registry, who were followed up for 10 years following an initial HPV test.

One cohort was made up of 7,218 women aged between 22 and 32 years who had a normal smear at the start of the study.

Of these, 17 per cent were positive for a high-risk HPV type at baseline.

The second cohort included 1,305 women aged 40 to 50 years who had a normal smear at the start of the study. Of these, just 3.6 per cent were positive for a high-risk HPV type at baseline.

Over the 10-year follow up, 22 per cent of the HPV positive women in the younger cohort experienced cervical abnormalities, compared to 8 per cent of HPV negative women.

In the older cohort, 30 per cent of those who tested HPV positive developed cervical abnormalities, compared with 7 per cent of those who tested HPV negative.

In addition, over 13 per cent of younger women, and over 20 per cent of older women, with a positive HPV test developed cervical neoplasia or cancer within 10 years.

The researchers concluded that HPV testing should be used to more accurately identify those at greatest risk of cervical cancer.

Lead researcher Dr Susanne Kjaer, head of the department of virus, hormones and cancer at the Danish Cancer Society, said: ‘Based on these results we feel that a HPV test would benefit older women, whether or not that test is used in conjunction with Pap smears or used by itself as an initial screen.’

GPletters@haymarket.com

Cancer Res 2006; 66: 10,630–6

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