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HPV test is better than Pap smear at detecting precancerous cervical changes study says

Since then, the conventional test was replaced by a liquid-based Pap cytology test, but now it seems that it might be replaced by a different test: the Human papilloma virus test (HPV test).

A new study called HPV Focal trial tests HPV tests with pap smear over 19000 canadian women over 4 years and found HPV tests are more accurate.

While co-testing catches more precancerous cells, it also raises the incidence of false positives, points out Dr. Diane Harper, a professor of medicine who researches HPV at the University of MI. Those in the Pap group who tested negative returned two years later for another and, if they tested negative again, returned at the end of the four-year study. At the four-year mark, all women were tested using both methods.

Massad has consulted with malpractice attorneys in cases alleging missed cervical cancer but declared he had no relevant financial relationships with industry. Some are still skeptical of relying on HPV testing alone, and co-testing, or using both the HPV test and a Pap smear, is still the standard. A study published in JAMA Tuesday suggests that method might be preferable for women aged 30 and over. They could also get a Pap test every three years. Rising geriatric population will also add fuel this market, as they will further demand for more cancer assays and tests and hence will contribute towards the growth of this market in future. Where it is hard to apply HPV tests over pap smear for United States as there hasn't been head to head comparison until now.

Cervical cancer screening is essential because almost 13,000 women in the USA are diagnosed with cervical cancer annually.

Women who had a negative HPV test at the start of the study were much less likely to develop CIN3+ within 48 months than women who had a negative smear test at the start of the study. Women with negative Pap smear results received a second Pap smear after 24 months. The US Preventive Services Task Force now recommends a Pap smear every three years or co-testing every five years for women age 30 and up, but it is considering changing that recommendation to just one test or the other, and this study could speed things along, NPR reports. Fewer cases of precancer were found in the HPV group, since that group had already had more precancerous signs identified and treated. They recommend further studies to help researchers understand long-term clinical outcomes and cost-effectiveness across both tests. The HPV FOCAL trial, which is the name given to this new study, analyzed tests from 19,000 women from Canada over the course of four years. Consistent with prior studies, more cases of abnormal cells in the cervix, known as cervical intraepithelial neoplasia (CIN), grade 3 or worse (CIN3+), were detected in the intervention group compared with the control group in the first round of screening.

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Women can get a clear result from a simple HPV test and those who receive a negative result will be able to trust those results for several years, she says. For those final results, both groups were tested using both the HPV test and the Pap test. He said that although the study confirmed previous research showing that the HPV test is more sensitive than the Pap test, it didn't answer a critical question: Is the HPV test alone better than the HPV test and the Pap smear together, as is current practice?

Most cervical cancers are caused by a particular strains of the Human papillomavirus, or HPV.

In addition to finding more precancers in the initial screening, women who had the HPV test had a "significantly lower likelihood" of having precancer in the cervix when they exited the study four years later.

"It's really incredible, there's no other test that gives us this level of reassurance for that period of time for a cancer", Harper says.

One caution about the study findings, says Dr. Carol Mangione, a USPSTF task force member and UCLA professor of medicine, is that screening - either kind - is what saves lives. They focused mainly on moderate or severe changes to cervical cells (pre-cancerous changes) that could lead to cervical cancer. Partly because of that, he said, "we're a long way away from replacing the Pap smear".

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