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The New HPV Test You Should Ask Your Doctor About

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How effective is it?

Last April, two scientists from the National Cancer Institute, writing in the prestigious New England Journal of Medicine about a study of 131,746 women in India, said that "among...women between the ages of 30 and 59 years...a single HPV test performed 15 to 20 years after the median age of first sexual intercourse will detect many easily treatable, persistent infections and precancers while limiting overtreatment." One test, they wrote, "dramatically reduced the incidence of advanced cervical cancer and cervical cancer mortality."

Why improve on the Pap?

This one test has made a huge difference in the health of American women; since the Pap's introduction in the 1940s, cervical cancer rates have been slashed by 70 percent, to 11,270 cases and 4,070 deaths in 2009. But the test has problems. For one, a single Pap can miss up to 50 percent of cell abnormalities (but because these changes usually occur very slowly, chances are great that an abnormality will be picked up on your next test). The Pap can also raise a false alarm when nothing's really wrong: Cervical tissue undergoes surface changes all the time, and these may pop up on your Pap, then disappear on their own. No screen can ever be considered 100 percent perfect, but the Pap/HPV combo comes pretty close. Studies from the U.S. and Europe show if you have negative results on the two tests given together, you can be 99.84 percent assured you won't develop cervical cancer within the next three or more years, says Alan G. Waxman, M.D., M.P.H., professor of obstetrics and gynecology at the University of New Mexico School of Medicine and lead author of the cervical-screening guidelines published by ACOG last December.

Do you still need an annual Pap test?

Actually, since 1987, virtually every medical organization that has issued guidelines on cervical screening has endorsed the idea that after three successive "normals," a healthy, low-risk woman age 30 or over needs to be tested only every two to three years. "The tradition of annual Pap tests is just that, a tradition, and it's not backed up by science," says Debbie Saslow, Ph.D., the American Cancer Society's director of breast and gynecologic cancers. Only women considered at high risk — DES daughters, for example, or those who've had cervical cancer or precancerous lesions — need more frequent tests. (Smoking also ups your risk; if you smoke, ask about extra tests.) Even if you don't have a Pap, though, you should have regular checkups that include breast and pelvic exams, a blood pressure reading, and other tests depending on your age and medical history.

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