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NEJM Report Finds HPV Test More Effective Than Pap in Determining Cervical Cancer Risk
Date:10/18/2007

ion to the HPV test's greater sensitivity, the study found that its specificity - the likelihood that women with positive results actually have disease - was only slightly less than the Pap's (94.1 percent vs. 96.8 percent).

HPV testing for routine cervical cancer prevention is currently most widely practiced in the United States, where it is approved for use along with a Pap in women age 30 and over. Under the currently recommended guidelines, screening that includes HPV testing may be performed at longer intervals than when the Pap is used alone. However, the authors of the NEJM report concluded that co-testing "only marginally improved sensitivity compared with HPV testing alone".

The conclusions of CCCaST reinforce a growing number of other studies showing greater sensitivity for HPV testing and suggesting its use as the primary, front-line screen -- with the Pap reserved for follow-up evaluation.(2) For example, most recently, the Oct. 4 issue of The Lancet reported on a trial involving more than 17,000 women in the Netherlands. The study, led by Professor Chris Meijer of VU Medical Centre in Amsterdam, concluded that HPV DNA testing detects pre-cancerous cervical cells earlier than the traditional Pap, thus allowing longer intervals between screenings. This is an important feature for health authorities working to control costs - particularly those in developing countries, where a variety of obstacles make it difficult for women to access regular medical care.

Medical experts agree that the most effective approach to cervical cancer prevention combines HPV vaccines for girls and young women with screening of older women.

"We believe that a shift from cellular to viral (screening) tests, coupled with education and vaccination, will contribute to more efficient control of cervical cancer," the authors stated in the NEJM report.

About HPV and cervical cancer

Worldwide, cervical cancer affects more than 400,000 women annually an
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SOURCE QIAGEN N.V.
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