Best Cancer Test: HPV vs. Pap Smear
Study Shows HPV Test Is Better Predictor of Cervical Cancer in Older Women
WebMD News Archive
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
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
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
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