HPV test tops Pap in cervical cancer detection

[mhatrw]

Source: Globe and Mail

Looking for the HPV virus is a far more effective means of detecting cervical cancer in its early stages than the traditional Pap test, according to new Canadian research. The study, published today in the New England Journal of Medicine, shows the test for human papillomavirus detected 95 per cent of cases in which women had precancerous changes to their cervix, compared with a 55 per cent detection rate with the Pap test. ...

The Papanicolaou (Pap for short) test requires a laboratory technician to spot abnormalities in cell samples under a microscope. The HPV test is an automated procedure that detects the DNA of high-risk strains of HPV. Dr. Franco noted that the detection rate using a Pap test is "only a tad better than flipping a coin." The test generates a lot of false negatives - meaning it misses some cases of cancer. The HPV test, on the other hand, generates some false positives, meaning it might suggest cancer when there is none. The HPV test gave a false reading 6 per cent of the time, compared with only 3 per cent for the Pap test. Dr. Franco said that, based on the research, he would like to see women screened for cervical cancer using the HPV test and, when the virus is detected, there is a follow-up test to look for cellular changes as is now done with a Pap test. "This would be a reversal of our current approach," he said.

Currently, screening for cervical cancer is done using the Pap test and, only when the results are unclear, is the HPV DNA test used. Another test, a colposcopy, is required to confirm a cancer diagnosis. A Pap test costs about $25, while an HPV test costs about $90. In most cases, only the Pap test is covered under medicare; the HPV test must be paid out-of-pocket.

Joan Murphy, head of the divisions of gynecology and gynecologic oncology at The University Health Network in Toronto, said the new study is "tremendously important" and she hopes it will prompt provincial health plans to offer HPV testing at no cost. Mass testing could bring the cost down to as little as $5. "This study shows us that an HPV test is much more reliable at picking up disease when it exists and, even more importantly, it's better at eliminating the risk of disease," Dr. Murphy said.

Read more: http://www.theglobeandmail.com/servlet/story/LAC.20071018.HPV18/TPStory/National

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The Pap smear has led to a 70% drop in the U.S. cervical cancer death rate over the past six decades, and there is so much more that we can and should be doing on the testing front to eliminate cervical cancer mortality.

[Tyler Durden]

1. Stop making sense.

What are you? Some kind of CANADIAN COMMIE???

If we started making that kind of sense here, why, we might save lives, or cut profits, or undermine the Holy War in Iraq.

:sarcasm: (Like THAT was necessary!)

[I Have A Dream]

2. K&R. n/t

[BlueIris]

3. Ditto.

[mhatrw]

4. Just a kick for those who might be interested who missed this. n/t

[hedgehog]

5. Does this mean cervical cancer is an STD?

[I Have A Dream]

6. Kick. (Sorry, hedgehog; I meant to reply to the original post.) n/t

[OzarkDem]

11. It means about 70% of cervical cancers

develop after someone is exposed to the HPV, an STD.

That's why cervical cancer vaccines were developed. Since most cases of cervical cancer are caused by a virus, they can be prevented with a vaccine.

Many lives will be saved as a result of the cervical cancer vaccine.

[DemBones DemBones]

15. HPV is an STD and HPV causes many, if not most,

cases of cervical cancer. I remember reading back in the Sixties or Seventies that studies had shown that women who had been married more than once had a much higher incidence of cervical cancer than those who had been married only once. Other studies showed that nuns almost never have cervical cancer. All that evidence suggested that there was an STD responsible for many cases of cervical cancer.

[kestrel91316]

16. In large part, YES.

[mzmolly]

7. I hope you'll post this in GD and Health?

I believe many of us mentioned this when we had the vaccine debates? :hi:

[iverglas]

8. having trouble following the plot?

I know I am!

Somebody must have taken a walk down the road to Damascus; I dunno.

How anyone could post this, apparently approvingly, and maintain that the connection between HPV and cervical cancer is tenuous (and, of course, cervical cancer just isn't that big a problem/deal) ... I for one am just confused.

Just by the bye, my province has now implemented an HPV vaccination program, covering girls in grade 8 each year:
http://www.hpvontario.ca/

[mzmolly]

9. Who said cancer isn't a big deal?

Most HPV clears on it's own, and early detection of cervical cancer is KEY, but I don't think anyone said "cancer isn't a big deal." There are simply different ideas as to how best to combat it, in this case.

[iverglas]

10. well, I didn't use the quotation marks

I don't think anyone said "cancer isn't a big deal."

but the author of the opening post has made it abundantly clear that s/he does not think that cervical cancer is a big deal.

Most HPV does indeed clear on its own -- and past infection may still be the trigger of cell changes and eventually cancer even though no HPV infection is present when they are detected.

Early detection of cervical cancer (or, preferably, pre-cancerous conditions) may be KEY to not dying. In my case, it wasn't key to my not losing most of my cervix in the aggressive biopsy procedure thought to be necessary to ensure my continued good health. I did.

I'm sorry if I misunderstood your initial contribution in this thread, and you are actually in the camp denying the HPV-cancer connection, or not agreeing that prevention is better than the kinds of treatment that are often necessary in order to prevent cancer or death.

[mzmolly]

13. I agree with prevention, I just don't think the vaccine has proven

itself at this time. The primary scientist who developed the vaccine has issues with how it's being marketed as well. FDA scientists have stated that the HPV vaccine can be a catalyst for cancer in some cases. Birth defects are also a potential issue. Further, no one knows how long any so called "protection" from this jab will last.

I simply don't think we know enough about the vaccine to suggest that it be given to children.

Peace

[DemBones DemBones]

14. I agree. Too often we find out that a vaccine

or drug is harmful only after it has damaged hundreds or thousands of people. Diethylstilbestrol (DES) is a classic example of a drug given to pregnant women from 1946 up into the Seventies. In the early days, it was thought to prevent miscarriages and so was routinely given to pregnant women who had previously miscarried a pregnancy. But after it was known that it did not prevent miscarriages, doctors still prescribed it to pregnant women.

DES was supposed to be "perfectly safe." I am a DES daughter and have had many medical problems due to my prenatal exposure to DES. I am one of the more "fortunate" DES daughters, though; some developed a rare vaginal cancer when they were teenagers, a cancer that had rarely before been seen in women under 60.

Recently I read that they are now seeing problems in DES grandchildren; meaning the children of DES daughters are being affected by a drug given to their grandmothers while they were pregnant with their mothers. Scary that it could have such a long-lasting effect.

There have been many other drugs that have turned out to have disastrous side effects. Contaminated polio vaccine in the Fifties, thalidomide in the Sixties, swine flu vaccine in the Seventies, etc. Big Pharma aggressively promotes drugs today, advertising them on tv, and employing drug reps who call on doctors regularly, convincing them to try new drugs on their patients.



The push to vaccinate young girls against HPV is a highly questionable practice. I believe it is being promoted due to Big Pharma's greed more than concern for women's health.

Do young girls need to be educated about HPV and other STDs? Absolutely. They need to know how to prevent pregnancy, too, and part of their sex education should be that their partner should always use a condom, since it protects against HPV, HIV, and other STDs and is effective in preventing pregnancy if used properly, especially with a spermicide.

Mandatory vaccination is a very bad idea, which will only enrich Merck and makers of other HPV vaccines while possibly causing more health problems than it prevents. Remember the vaccine does not protect against all strains of HPV, which makes it about as effective as using condoms with tiny holes in them.

[mzmolly]

17. Fully agree.

I'm sorry about your experience. I also often wonder what we "don't" know.

[mcscajun]

12. My GYN says the same. Based on my last negative result on the HPV test,

he says I don't need a Pap test for three years. He's a conservative doctor who treats agressively when it's appropriate, if that makes sense. I'm a high-risk patient with extensive family history of female cancers, and in addition to routine mammograms and annual gyn exams, I've had repeated trans-vaginal ultrasounds, a colposcopy, and more than one endometrial biopsy. If he says I don't need a Pap test for a couple of years, I'll believe him.