Munich (dpa/tmn) Experts say HPV (Human Papillomavirus) testing, which is often offered at women's clinics as a self-pay service, is not enough to determine the risk of cervical cancer in women. A pap smear test is more exact.
The HPV test only confirms whether a woman carries the virus, which is the cause of most cases of cervical cancer. It does not confirm illness or predict future illness. In more than 90 percent of the cases, an infection is no longer detectable after an average of 13 months, explained Christian Albring of the Professional Association of Gynaecologists (BVF) in Munich. This is because the body's immune system clears HPV naturally within that time. Therefore, the positive predictive value of the test lies at 10 percent.
The pap smear, which is done during the annual examination for early detection of cancer at the cost of one's health insurance, is of more significance. According to Albring, during cell analysis, 7 out of 10 women who have shown suspicious cell changes have in fact, a cervical disease requiring treatment. The BVF president cites recent research from Australia, where the positive predictive value of the pap smear is more than 70 percent.
HPV is transmitted by skin to skin contact through vaginal, anal and oral sex with a partner who already has HPV. If infected, signs and symptoms may take weeks, months and even years to appear. Symptoms may never appear.
|I don't agree and neither do the Dutch. The new program recommended by their Health Council will be 5 hrHPV primary triage tests offered at ages 30,35,40,50 and 60 and ONLY the roughly 5% who are HPV+ and at risk will be offered a 5 yearly pap test. This is smarter testing, it spares the vast majority of women from a lifetime of unnecessary pap testing with the fairly high risk from false positives, excess biopsies and over-treatment. (which can damage the cervix and lead to premature babies, c-sections, cervical cerclage, miscarriage etc) It will also, save more lives by focusing on the roughly 5% at risk and is more likely to prevent/detect this rare cancer including, adenocarcinoma of the cervix, usually missed by pap testing. The Dutch are also, already using the Delphi Screener, a HPV self-test device invented by Dutch gynecologists. (also, available in a few other countries) Those women who are HPV- and no longer sexually active or confidently monogamous might choose to stop all further testing. Evidence based testing is a much better deal for women, the vast majority who cannot benefit from pap testing (but are exposed to risk) and the fairly small number at risk. The Dutch are the ones to watch here...see HPV Today, Edition 24 and the Delphi Bioscience website for information on HPV self-testing. Pap tests are not recommended for those under 30, there is no benefit, the same rare cases will occur whether you test or not, but testing leads to high over-treatment. Young women produce the most false positives. HPV primary testing is also, not recommended for those under 30, approx. 40% would test positive when almost all are transient and harmless infections that will clear within a year or two. By age 30 approx. 5% of women are HPV+ and these are the women who have a small chance of benefiting from a 5 yearly pap test. We need to be careful with cancer screening and make sure it's in our best interests. It can harm us...|
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