Many might imagine that only women “of a certain age” get cervical cancer, but that’s not true — women of all ages must be screened. Now, some women will have access to a new option for screening.
New government guidelines developed by an expert panel — the U.S. Preventive Services Task Force (USPSTF) — state women between 30 and 65 may undergo screening for cervical cancer by getting tested for high-risk strains of human papillomavirus (HPV) every five years. This frees the patient from having to have a Pap test too.
The USPSTF previously recommended the use of both tests every five years for the age range. The co-testing method is less-preferred since it requires women to undergo more procedures and tests, compared to Pap testing alone or HPV testing alone. Another alternative exists, per the guidelines — getting the Pap test done every three years. The guidelines haven’t changed for women under 30 and over 65.
Keeping Screening Necessary
Women now have more choices to screen for cervical cancer, but the primary concern remains encouraging women to get screened in the first place. The USPSTF stresses the need to focus on adequate screening, no matter the method chosen, since regular screening will ultimately lead to lowering cervical cancer rates.
The findings have come a long way in terms of protection and detection. In a 1989 study, papillomavirus DNA was found in the vapor of warts that were treated by carbon dioxide laser. The study revealed the dangers of possible inhalation exposure to papillomavirus. This essentially meant that the risk of exposure to this disease is even higher than wehad initially believed, although high-risk HPV strains spread via sexual contact still cause nearly 90 percent of cervical cancers.
Many HPV infections do clear up by themselves, but the virus can linger and lead to an eventual diagnosis of cervical cancer. Both the Pap and HPV tests analyze a woman’s cervical cells, but the Pap test looks at whether or not they’re cancerous while the HPV test searches for HPV infection. Co-testing itself takes one swab, but doing both tests can heighten women’s nerves.
Why Update the Guidelines?
The update has come as a result of revelations from current studies. It was discovered that testing for high-risk HPV strains, rather than using Pap tests, led to an increased rate of discovery of precancerous lesions within the cervix . The study proved the strong effectiveness of high-risk HPV testing utilized alone to screen for cervical cancer.
Both co-testing and HPV testing alone proved a little more effective to reduce cervical cancer mortality rates than Pap tests alone, per a recent study in JAMA. A simulation model found that 830 in 100,000 women died of the cancer if they went without screening, and the model also found:
- If women screened with only the Pap test, the mortality rate decreased to 76 deaths for every 100,000.
- The death rate dropped to 30 deaths for every 100,000 women with co-testing starting at age 30.
- If women screened every five years with HPV testing, starting at age 30, the mortality rate decreased to 29 for every 100,000 women.
Any Downsides to Choosing the HPV Test?
Co-testing and HPV testing alone both maintain increased rates of false positives than using the Pap test. Co-testing holds the highest rate of false-positive results, but the USPSTF states that each of the recommended screening methods — co-testing, Pap testing alone and HPV testing alone — offer reasonable balance between harms and benefits.
The guidelines suggest that women could possibly conduct HPV testing for high-risk strains effectively at home. Women would provide their sample and mail it to a lab for analyzing — much like modern ancestral DNA testing. This would also increase screening rates while decreasing mortalities from cervical cancer thanks to prevention. This method also could potentially make women feel more comfortable about the procedure since they’re doing it themselves, especially women who have fears related to gynaecological exams.
Additional studies will determine if HPV vaccinations, which lower HPV infection risk, might affect how HPV testing functions in cervical cancer screening. However, this could be a great shift for many women — time will tell, but we’re hopeful.