HPV Test versus Pap Test in Cervical Cancer Screening: which is better?

In past years it was discovered that some Human Papilloma Virus (14 HPV types identified) are responsible for

Dr Filiberto Di Prospero

Dr Filiberto Di Prospero, Medical Director of the Gynecologic Endocrinology Unit at Civitanova Marche General Hospital.

cervical cancer. This evidence led for the first time in medicine to have an effective vaccine against cancer but undoubtedly led to important changes on secondary prevention and diagnostics to.

Although HPV infections are extremely common in women under 30, they usually go away on their own before they cause problems. Thus, medical guidelines until now have not recommend routine HPV testing in this age group.

HPV Test uses a sample of cervical cells to identify hight-risk types of HPV; it is very well known and already widely used in many countries.

Recently US Food and Drug Administration approved the use of HPV DNA Test for cervical cancer screening in women 25 or older. In fact the test has proven to be safe and effective at detecting high-risk types of HPV that are more likely to lead to cervical cancer (specifically 16 and 18). Although several panel members did express concerns about overtreatment in the 25-29 age group, ultimately they agreed that the benefits outweigh the risks.

Then from now the HPV Test can be used alone, without a Pap smear in cervical cancer screening. But note that is an optional strategy, that can be discussed with health care providers and that not change the actual guidelines or recommendations for Pap smear (recommended every three years for womens 21-65).

What should you do if you have a positive HPV test:

  • if the 16 or 18 HPV virus types are identified, is recommended for you to get a Colposcopy;
  • if you have an other HPV types positivity you should perform a Pap smear to decide further investigations.

So even if you chose the HPV test as your personal screening method it can not completely replace the Pap Test that may be required from your Doctor.

Certainly an integration of the two tests (combined test) could lead to check women every 5 years, but the economic aspect need to be carefully evaluated.

For now the choice of HPV test screening is a women’s choice. If you’re over 25 and would prefer to use this screening method instead of your usual Pap smear, now you can. What is your choice?

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Filiberto Di Prospero
Medical Doctor, Consultant in Gynecology and Obstetrics, Endocrinology and Metabolism. Director of Gynecologic Endocrinology Unit at Civitanova Marche General Hospital (Italy). Private clinics in Civitanova Marche, Rome and Milan.

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