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Add-on HPV test for cervical screening
15 December 2011
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Cervical screening using a human papillomavirus (HPV) DNA test with a smear test could lead to earlier detection of pre-cancerous cells of the cervix when compared to using a smear test alone, according to research published in the Lancet.
The HPV DNA test detects the types of HPV that are associated with cervical cancer. HPV is a very common sexually transmitted infection (STI). There are over a hundred different types of HPV. Around 13 of these can cause cancer – the other types are harmless or can cause genital warts.
Researchers looked at nearly 45,000 women aged 29 to 56 who were enrolled in a cervical screening programme in the Netherlands. They randomly assigned the women into two groups. In the first round of screening, one group of women had the HPV test with a smear test, whereas the second group had a smear test alone. Five years later in the second round of screening, both groups of women had the HPV test with a smear test.
At the end of the study, the researchers found that there were less severe changes to the cells of the cervix in the women who had both HPV testing with a smear test in the first round of screening, compared to those who had the smear test alone. Cervical cancer was also less common in these women.
The researchers believe that using the HPV test with a smear test in cervical screening led to earlier detection of changes in the cells. This helped with early treatment and prevented further changes to the cells, or even cervical cancer. These results support the findings of previous studies.
Dr Ryan Mehta, Project Clinical Director for Bupa Health and Wellbeing, said: “This is a large study with encouraging results. The HPV test is a simple add-on that you can have at the same time as a smear test, so it wouldn’t cause any additional discomfort or worry.
"There are a number of risk factors for cervical cancer, including smoking, having sex at an early age, and having many sexual partners or having a partner who has had many partners. As the HPV infection can be passed on through unprotected sex, it's important to target younger women who are typically more sexually active and have more partners and are therefore more at risk of getting the HPV infection. It’s really interesting to see that the researchers suggest screening younger women between 29 and 33 could result in fewer false positive results. This is where screening can show possible signs of cervical cancer when in fact there isn’t a problem.
“It's important to remember that although cervical screening is the best way of checking the health of your cervix, it isn't a perfect test. If you have a false positive result, you will be asked to have further tests, which can cause unnecessary worry. Despite this, cervical screening programmes have been shown to prevent cancer and be very successful.
“If you have any concerns about cervical screening, speak to your GP.”
Key facts
- Cervical cancer is a type of cancer that affects the neck of your womb (cervix).
- Almost all cases of cervical cancer are caused by HPV. HPV can infect the cells on the surface of your cervix and damage them, causing changes in their appearance. Over time, if left untreated, these changes can lead to cervical cancer.
- The age for screening varies from country to country. For example, in the Netherlands women aged between 30 and 60 receive routine screening. Whereas in England, women aged between 25 and 64 are invited for screening.
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Read the study
Rijkaart DC, Berkhof J, Rozendaal, et al. Human papillomavirus testing for the detection of high-grade cervical intraepithelial neoplasia and cancer: final results of the POBASCAM randomised controlled trial. Lancet Oncol 2011; online first. doi:10.1016/S1470-2045(11)70296-0
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