Are Pap Smears a Thing of the Past?
Pap smears are routine screening tests for cervical cancer. This screening was first introduced in 1928 but not widely used until years later. Today it is recommended for most women between the ages of 21 and 65 years old. Most women get a pap test during their annual gynecological exam. More recently, an HPV test, which looks for the presence of the human papillomavirus (HPV), has been found to be more successful in determining cervical cancer risk.
A pap test looks for abnormal cells on your cervix. During a gynecological exam, your doctor scrapes your cervix, removing some cells. These are then looked at under a microscope for any abnormalities. The test is not used to diagnose cervical cancer; rather it identifies those at risk of developing the cancer. If abnormalities are found, your doctor recommends further testing, usually either repeating the test or a colposcopy, which is looking directly at eh cervix using a microscope.
The HPV test is also done on cells collected from your cervix. But instead of looking for abnormal cells, it looks for the presence of the two strains of HPV that cause most cervical cancers. This test was recently approved by the U.S. Food and Drug Administration (FDA) as a primary screening tool for cervical cancer.
Comparing the Pap Test and HPV Testing
A recent study, published in the Journal of the National Cancer Institute, showed that the HPV test was more accurate in determining a woman's risk of developing cervical cancer. A previous study, published in The Lancet also found the HPV test to be more successful than the Pap test. Even so, experts aren't quite ready to give up on the Pap test. While the HPV virus causes most cervical cancers, some are not caused by the virus and experts are concerned that those cancers will go undetected. The other concern is that women who have a positive result on the HPV test will be given additional unnecessary tests and procedures. Many times the virus will clear up on its own, therefore, not everyone who tests positive for the virus will develop cancer.
In March, 2014, an FDA Advisory Board suggested that HPV testing could replace, or at least be the first-line test for cervical cancer screening. According to the FDA Board, women who tested positive for the HPV strains that most commonly cause cervical cancer should then have a colposcopy. Women who tested positive for other types of HPV viruses should have a pap smear.
It's more likely that doctors will use a combination of both the Pap test and the HPV test. In 2012, the U.S. Preventive Services Task Force issued guidelines for screening for cervical cancer, including women ages 21 to 65 years old should have a pap smear every three years, or every five years if combined with HPV testing. These guidelines are still in place today, however, as more research is completed, the guidelines might be revised.
For now, the best course of action is to talk with your doctor about the pros and cons of both tests to determine what is best for you.