HPV Testing for Cervical Cancer More Sensitive than Cytology

A new study found that the test for human papillomavirus (HPV), which is present in most cervical cancers, is more sensitive than cytology in detecting cervical cancer.

The current technique for screening for cervical cancer involves microscopic examination of cells collected by way of a pap smear. This method has reduced cervical cancer in countries where it is regularly used but it has several limitations. High-quality samples must be collected and identification of cell changes is very subjective. In addition, the method is very repetitive, which can lead to interpretive errors.

Several studies have indicated that HPV testing is more sensitive than cytology at detecting cervical intraepithelial neoplasia (CIN), the changes in cervical cells that can lead to cancer. The current study, led by Jack Cuzik, Ph.D., of the Cancer Research UK department of epidemiology, mathematics, and statistics at the Queen Mary School of Medicine (London, UK) performed an overview of data for more than 60,000 women in the United Kingdom, France, Germany, the Netherlands, United States, and Canada. The results showed that HPV testing was very sensitive (96% overall, and that this sensitivity was not affected by the age of the patient. Cytology was substantially less affective (53% overall, although results varied widely). The study results were reported in the April 3, 2006, International Journal of Cancer.

"HPV testing is highly reproducible, more easily monitored, provides an objective test outcome, and can be easily automated,” noted the authors. Since only persistent HPV infections are thought to be associated with pre-cancerous lesions, they suggest that procedures need to be developed for repeat testing to detect infections that may be transient, especially in younger women. They also suggest performing the HPV as the sole primary test, followed by cytology--the more specific test--in those who test positively initially.

The International Agency for Research on Cancer (IARC, Lyon, France) concluded that HPV testing could reduce the incidence and mortality from cervical cancer, and that it is likely to be at least as effective as cytology. The English Cervical Screening Advisory Committee has agreed that the HPV test could be used by the national screening program.



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Queen Mary School of Medicine
IARC