HPV Test Vs. The Pap Smear - What's Better?

I know when it's time to go for my annual medical exam, its' confusing to figure out which tests are best for detecting a potential problem. These days there seems to be a laundry list of choices, and we're left to figure out which one is best. For early detection of cervical cancer it has always been the Pap smear, but maybe that's about to change.

Now researchers at McGill University in Montreal have released some new information.  Their studies are showing that the HPV screening test is superior to the traditional Pap test in detecting cervical cancer. Accuracy for the HPV test was 94.6%, compared to 55.4% for the Pap.  This was reported in The New England Journal of Medicine, October 18th issue.

The controlled randomized trial, called CCCast, was the first of its kind carried out in North America for HPV testing as a stand-alone screening for cervical cancer.  Initially, it involved 10,154 women during the period 2002 - 2005. These women were anywhere from 30 - 69 years old.

Although HPV tests were 40% more accurate than Pap tests, as far as the specifity scale was concerned, the Pap test faired better. Pap tests' ability to accurately detect pre-cancerous lesions without false positives was better - 96.8% compared to 94.1%.

The researchers explained "We already knew before conducting this study that the sensitivity of Pap left a lot to be desired. However, 55.4% accuracy is only slightly above chance. Flipping a coin gives you 50%." Don't you think that's shocking?    There is no doubt in my mind that we've been treated like second class citizens far too long - 55.4% are they kidding?  We deserve so much better, but it's only going to happen if we stand together and make it happen.

The Pap test, which was created by Dr. Georgios Papanicolaou during the 1940s, require that cell samples are gathered from the patients cervix and examined under a microscope by technicians. This procedure has been the norm for more than half a century. The HPV test, on the other hand, although requiring cervical samples, is analyzed automatically - it detects the DNA of HPV strains which are known to cause cervical cancer.

A test's sensitivity is generally thought of as more useful than specifity. Event though a false positive is psychologically distressing, the patient is free of the disease, explain the researchers.

So, as I'm writing this I'm thinking, why not perform both tests to get a far better reading and increase the odds? I'll just bet it has something to do with the insurance company restrictions, but I'll find out for sure and and report back to you.

Read the article at McGill University web site.