Watchful Waiting Best After HPV Test?

Studies: HPV Test May Beat Pap Test at Detecting Risky Cervical Cells, but It May Take Time

By Miranda Hitti
WebMD Health News

Reviewed By Louise Chang, MD

March 25, 2008 — Human papillomavirus (HPV) tests may be better than the Pap test at predicting abnormal cervical cells that could lead to cervical cancer, new research shows.

HPV is a common, sexually transmitted virus. Several types of HPV make cervical cancer more likely. But in most women, HPV infection doesn't last long and doesn't lead to cervical cancer.

HPV tests aren't intended to replace the Pap test or to screen women younger than 30 who have normal Pap tests, according to the FDA.

Last October, Canadian researchers reported that the HPV test trumps the Pap test at detecting precancerous cells.

Now, two new studies suggest that if a woman tests positive for HPV — especially if she's younger than 35 — it might be appropriate for her to wait a year to see if her HPV infection clears up before she gets more cervical cancer tests.

The first study included more than 49,000 women in Italy. They either got an HPV test or a Pap test.

Among women aged 35-60, HPV testing was more sensitive than the Pap test at predicting which women developed precancerous cervical cells.

But HPV infection is more common in younger women. And in the Italian study, women aged 25-34 who tested positive for HPV often had fleeting HPV infections that didn't lead to abnormal cervical cells.

The researchers suggest that women younger than 35 who test positive for HPV get another HPV test a year later, and only get further cervical cancer screening if they still have HPV.

The second study, conducted in Costa Rica, confirms that HPV infections often clear up, and that persistent HPV infections are riskier.

"These findings suggest that the medical community should emphasize the persistence of cervical HPV infection, not single-time detection of HPV," write the National Cancer Institute's Ana Cecilia Rodriguez, MD, and colleagues.

SOURCES: Ronco, G. Journal of the National Cancer Institute, April 2, 2008; vol 100: pp 492-501. Rodriguez, A. Journal of the National Cancer Institute, April 2, 2008; vol 100: pp 1-5. News release, Journal of the National Cancer Institute. News release, FDA.

© 2008 WebMD Inc. All rights reserved.


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