Commentary: New Tests for Cervical Cancer Unwarranted
Nov. 17, 1999 (Atlanta) -- New tests promising increased accuracy of Pap smear laboratory analysis have not been backed up by rigorous science and could be misleading the public, according to an analysis of previous research studies published in a recent issue of the medical journal Obstetrics and Gynecology.
The researchers who analyzed the studies say that advertising aimed directly at consumers "preys on the fears of women" by implying that they should be demanding new laboratory methods for detecting cancerous or precancerous cells taken from the cervix.
Instead, they say, according to the studies, the tests -- in addition to being more expensive than traditional Pap smear analysis -- so far have not shown a clear superiority.
"The biggest risk of cervical cancer is [that of] not getting screened at all," co-author David Grimes, MD, tells WebMD. "The risk of missing a cancer is exceedingly remote. It's not the fallibility of Pap smears, it's just that people don't get them." Grimes is clinical professor of obstetrics and gynecology at the University of North Carolina at Chapel Hill.
According to a 1996 report by the National Institutes of Health, about 15,700 U.S. women are diagnosed with cervical cancer every year, and nearly 5,000 die annually. The report notes that about 50% of women who develop cervical cancer have never had a Pap smear test.
"We don't need to screen the same women better," says researcher George Sawaya, MD. "We need outreach to women who don't get screened. Most women who've been screened often in their lifetime will never get to the point of getting cervical cancer."
When detected in time, precancerous lesions on the cervix can be removed or otherwise inactivated before tumors develop.
With the new testing technology, after a cervical-tissue sample (Pap smear) has been obtained, the cells are captured in a liquid formula -- which provides more cells for analysis -- instead of being placed on a "dry" slide for evaluation. But after reviewing the clinical studies that preceded FDA approval of the new testing method, the researchers found similar rates of accuracy -- and "scant evidence [the new tests] are better."