HPV test more sensitive than PAP smear for detecting cervical cancer lesions

Findings from researchers, published in the British Medical Journal, reveal that HPV (human papillomavirus) testing is more sensitive for detecting precancerous lesions that can lead cervical cancer, compared to PAP smear. Dr Ahti Anttila at the Finnish Cancer Registry who led research says the findings that HPV testing is more sensitive than PAP smear are important for cervical cancer prevention.

In a trial of 58,282 women aged 30-60, HPV testing detected more precancerous cells than routine cytology exam performed with a traditional PAP smear.

Women were studied between 2003 and 2008 in Finland and randomly assigned to a routine PAP smear or an HPV test. For women with positive HPV testing, further screening was conducted. Traditional cancer screening using a PAP smear was inferior for detecting cervical lesions that could lead to cancer compared to HPV testing.

Over a period of five years the women were tracked. The number of pre cancerous cells (cervical intraepithelial neoplasia or CIN III+)detected with HPV testing in the study was small, but the researchers concluded "considering the high probability of progression of CIN III lesions in women aged 35 years or more, our results are important for prevention of cervical cancer."

HPV is sexually transmitted and affects young women and adolescents. HPV can lead to cervical cancer, while some forms cause genital warts. Based on the high sensitivity for detecting precancerous lesions in the cervix, the researchers say gradual incorporation of HPV testing for prevention of cervical cancer is justified.

BMJ 2010;340:c1804