Advances in Cervical Cancer Screening

By Michael Zerres

Recent Data Supports the Use of HPV Testing

Cervical intraepithelial neoplasia is the abnormal growth of precancerous cells in the cervix. Most such cases remain stable or are eliminated by the host’s immune system without intervention. However a small percentage of cases progress to become cervical cancer – which is the second most common cancer in women worldwide – despite the availability of PAP testing for at least the last 50 years.

The major cause of cervical intraepithelial neoplasia lesions is infection with the sexually transmitted human papillomavirus (HPV). A recent study in the New England Journal of Medicine shows that HPV testing is more sensitive than standard PAP smear testing for the screening of cervical-cancer precursors. In fact, HPV testing was almost 40% more sensitive that testing by PAP smear.

The trial, conducted by Dr. Marie-Helene Mayrand and colleagues at McGill University in Montreal, concluded that while the sensitivity of PAP testing for Grade 2 or 3 pre-cancerous cervical lesions was 55.4%, the sensitivity of HPV testing for the same lesions was 94.6%.

The results clearly suggest that, in addition to routine PAP screening, women should incorporate HPV testing as a screening tool for pre-cancerous cervical lesions. The availability of such dual screening would likely reduce the incidence of cervical cancer, as the pre-cancerous lesions identified during screening tests can be surgically removed with a laser before they develop into a true malignancy.

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