HPV test can provide better comfort against the cervical cancer than the Pap test
In the United States, cotesting for the human papillomavirus (HPV) and Pap test for cervical cancer every 5 years for women aged 30-65 years is now recommended. However, the only HPV test can provide better comfort against the cervical cancer than Pap testing alone and reassure similar to cotesting, according to a study published in the July 18 Journal of the National Cancer Institute .
In a comparison of the three strategies, Julia C. Gage, Ph.D., MPH, of the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, and colleagues analyzed data from the Kaiser Permanente Northern California (KPNC) large integrated health delivery system, which screened women aged 30-64 since 03 with both the HPV and Pap test. Data were available until 2012, and more than 1 million women were examined at intervals of about 3 years, with an average follow-up time of 4.36 years. For each test strategy, they estimated the cumulative risk of cervical cancer after a negative test result.
The researchers found that the risk of cancer 3 years after a negative HPV test result alone were lower than Pap -alone negative. In addition, the risk of cancer 3 years after a negative HPV test result-alone were similar to the risk of cancer for 5 years of negative co-test. Gage et al. write "In conclusion, we find that the primary HPV test every 3 years could provide as much if not more reassurance against precancerous and cancer, compared to primary Pap test every 3 years and cotesting every 5 years." However, the authors note that a screening program based on any single test, rather than a program like that cotesting KPNC could give slightly different estimates. They ask for studies of screening programs in different contexts and health communities to identify the optimal screening strategy and interval.
In an accompanying editorial, Jane J. Kim of the Harvard School of Public Health, Department of Health Policy and Management, Center for Health Decision Science, Boston, MA, also warns that the data reflect management based on cotesting and notes that the HPV test approved for primary screening assays specifically the two types of HPV highest risk (16 and 18) which represent 70% of cervical cancers, but analysis of pools for the other 12 strains of HPV. However, despite these caveats, Dr. Kim concludes that the authors' -Ensure timely evidence of the United States as the primary screening HPV can reassure equal to or against the risk of cancer than currently recommended strategies by guidelines. "
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