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Study shows HPV screening more effective than Pap test

Photo: HPV screening more effective than Pap test
A study by the Cancer Council NSW has confirmed HPV screening is more effective at detecting high-grade cervical abnormalities than a Pap test.

The new national cervical cancer screening program has received a boost, with a large clinical trial showing screening for the human papillomavirus (HPV) is significantly better at detecting potential precancerous cells than the traditional Pap smear.

"We found that the HPV test was substantially more effective at picking up high-grade abnormalities compared to the Pap test," said Professor Karen Canfell, Director of Research at Cancer Council NSW.

The results, published in international journal PLOS Medicine, have been released less than three months ahead of the transition to the new national cervical cancer screening program that eliminates the need for women to have a Pap smear every two years.
From December 1, women from the age of 25, instead of 18, will be required to have a five-yearly human papillomavirus (HPV) test, replacing the two-yearly Pap test.

Previous estimates have suggested the new screening program would lower cervical cancer incidence and mortality by at least 20 per cent due to the more accurate test.

However until now it had not been tested among women with a high uptake of the HPV vaccine.

To examine its effectives, researchers at Cancer Council NSW and the Victorian Cytology Service compared the detection rates of high grade cervical abnormalities with the Pap test among 5000 women aged 25 to 64.

The women attended a routine screening at 47 participating clinics in Victoria.

They were randomly assigned to either have a five-yearly HPV screening test or a 2.5-yearly liquid based cytology screening (Pap test).

The study found that compared to the Pap test, HPV screening "significantly" increased detection of high grade precancerous cervical lesions among those who had been vaccinated. The overall detection rate was 0.1 per cent versus 2.7 per cent, respectively.

"These findings provide initial support for the implementation of primary HPV screening in vaccinated populations," the authors wrote.

Prof Canfell says increased detection means greater longer-term protection against the development of invasive cancer.

"This adds to existing evidence about how much more accurate and effective HPV screening is. We now have a superior method for detecting no just the virus that causes cervical cancer, but also high-grade abnormalities," she said.

The second phase of the Compass trial is currently recruiting and hopes to have more than 120,000 participants.

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