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Best Cancer Test: HPV vs. Pap Smear

Study Shows HPV Test Is Better Predictor of Cervical Cancer in Older Women

Better Long-Term Predictor continued...

Twenty-one percent of the older HPV-positive women with negative Pap smears developed cervical cancer or precancerous cervical lesions within 10 years, compared with just 1.7% of women who tested negative on both screening exams.

As expected, HPV infection was more common in the younger women (17%) than in the older women (3%). And the older women who tested positive for HPV tended to have more severe cervical abnormalities than the younger women.

The study is published in the Nov. 1 issue of the journal Cancer Research.

Current Guidelines

The American Cancer Society (ACS) recommends that all women begin having annual Pap test screening within three years of having vaginal intercourse, but no later than 21 years of age.

Beginning at age 30, women who have had three normal Pap tests in a row may choose to be screened every two to three years.

Women over 30 can also opt to have a Pap test and an HPV test. But if both tests are negative, neither test should be repeated for at least three years.

ACS director of breast and gynecologic cancer Debbie Saslow, PhD, tells WebMD that the clinical evidence, including the Danish study, suggests that these guidelines are right on target.

"These are very different tests," she says. "We know that HPV testing is a better predictor of who will develop cervical disease and Pap tests tell you what is going on today."

She says Pap testing without HPV remains a very effective cervical cancer screening tool as long as ACS guidelines are followed. This is true for both younger and older women.

HPV testing can tell older women more about their long-term risks of developing cervical disease.

"A negative [HPV] test is almost a sure sign that a woman will have nothing to worry about for at least five years, and maybe longer," she says. "But if a woman in her mid-30s or 40s has two positive tests over two years, that is a good sign that something is going on, even if her Pap test is normal."

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