Which Test is Best For Cervical Cancer?

Pap? HPV? Boston Medical Center researchers say it’s best to do both, with some caveats.

There seems to be a lot of confusion out there when it comes to cervical cancer screenings. Is a Pap test enough? Do we also need an HPV test? Can one replace the other or do we need both?

For more than 60 years, the Pap test has been, what BMC reps say, is a “cornerstone of women’s health.” If you’re a female over the age of 18, you most likely get an annual Pap test as part of your normal checkup. But in late-April of this year, the FDA approved the Cobas HPV test as the new primary screening tool for cervical cancer for women aged 25 and older. However, this also brings up a lot of questions about which test, if any, is the best for cervical cancer screening.

In the June 9 edition of Annals of Internal Medicine, Rebecca Perkins and Elizabeth Stier, doctors Boston University School of Medicine (BUSM) and Boston Medical Center (BMC), provide insight into cervical cancer screenings and the advantages, disadvantages, and possible benefits of both tests.

The report says that although the merits of screening tests and screening intervals still needs further discussion, they firmly believe that “increasing the number of women who participate in cancer screenings and ensuring that women are not lost to follow-up with lengthened screening intervals is more important than the choice of test to decrease rates of cervical cancer.”

According to the researchers:

Testing with both Pap and HPV together (co-testing), detects the most cervical pre-cancer, but the improvement over HPV testing alone is small. “A single Pap test does not provide good protection against cancer, but repeat testing every three years has been shown to effectively reduce cancer rates, and it is the only method for which long term data are available,” explained co-author Rebecca Perkins, MD, MSc, assistant professor of Obstetrics and Gynecology at BUSM and a gynecologist at BMC. Questions remain however regarding the cost of each test, and how often women will be asked to be screened.

“We also must remember that the majority of cervical cancers occur in women who have not had any recent screening and that increasing HPV vaccination rates will also be important to reducing cervical cancer rates in the future,” Perkins said.

The bottom line: Getting both tests is best, but a Pap alone will not provide the best protection. The docs say that getting screened is the most important thing you can do. Be sure to get a Pap every three years and use the new HPV test as the main form of cervical cancer screenings. If you are 26 or under, you should also consider the HPV vaccine.