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Virus test better than smear

22nd October 2007

It may be far more effective to test directly for the virus which causes most forms of cervical cancer than to try to detect tumours in the early stages using the traditional smear test, a Canadian study has shown.

cervical cancer

Canadian researchers led by Eduardo Franco of McGill University in Montreal said a simple test for the human papillomavirus, or HPV, successfully flagged up 95% of cases of early cell changes or cervical tumours.

This compared with a success rate of just 55% for the pap smear.

The study looked at 10,154 women in Montreal and St. John's, using both the pap smear and the Qiagen virus test for HPV, which is transmitted sexually.

In a pap smear, doctors scrape a small cell sample from the woman's cervix, which is then examined for signs of abnormality in the path lab.

Cervical cancer is caused mostly by two strains of HPV, and affects around 11,000 women in the United States annually. Around 4,000 of those die.

The HPV test found more cases of active infection and of precancerous lesions, Franco's team reported in the New England Journal of Medicine.

However, it also gave a false positive in 6% of cases, compared with a false positive rate of just 3% for a pap smear.

This is because an HPV infection can disappear without causing cancer, or it may take time for it to produce abnormalities in a cell.

Published in the same issue of the same journal, a Swedish study found that combining both types of tests increased the detection rate by 51%

Led by Pontus Naucler of Lund University in Malmo, researchers used an HPV test in 12,527 Swedish women in their thirties.

Franco wrote that while HPV tests are currently more expensive than pap smears - US$90 (£44) versus US$10-20 (£5-10) - mass production could bring that cost down. The two tests could then be used in combination for maximised cost effectiveness, he said.

 

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