HPV Testing Offers Women Longer Protection than Smear Testing

Testing for human papillomavirus (HPV) can be twice as effective at protecting women from developing cervical abnormalities as smear testing.

Nearly 3000 women aged 35+ were recruited into a study between April 1994 and September 1997. They were asked to participate in the study in which HPV testing would be performed in addition to cytology (smear test) whilst attending their general practitioner (GP) practice (40 practices were involved in the trial) for a routine cervical smear.

All women tested were followed up passively using data from the national computerized system that records all smears and their results--the Open-Exeter system. Women with a smear history indicating the need for colposcopy--a more thorough examination of the cervix--were investigated further to determine whether the colposcopy and biopsy were performed, and what the resultant outcome was. Passive follow-up was complete for all women by early 2005.

Results showed that the risk of developing cervical abnormalities at one, five, and nine years after a normal smear test was 0.33%, 0.83%, and 2.20% respectively, with those odds significantly reduced after a negative HPV test--0.19%, 0.42%, and 1.88%, respectively.

The study was led by Prof. Jack Cuzick of Barts and The London School of Medicine and Dentistry (London, UK) and the results were published on May 15, 2008, in the International Journal of Cancer.

Prof. Cuzick said that HPV testing "offers women excellent protection from cervical abnormalities for at least six years after a negative test, compared to protection from a normal smear test which begins to wane after about three years. This suggests that the screening interval can be safely extended to at least six years with HPV testing. These data provide more support for replacing screening based on abnormal cells, with a more sensitive test based on screening for the human papillomavirus.”


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Barts and The London School of Medicine and Dentistry