The guidelines for how often to see your gynecologist have changed enough in recent years to be a little confusing: Medical experts used to recommend annual pelvic exams, but have since amended that recommendation to once every three years for women with no gynecologic problems. A pelvic exam is different than a Pap smear, the test that involves scraping the cervix to test for abnormal cells that may lead to cervical cancer. Currently, the American College of Obstetricians and Gynecologists advises that women under 30 have a Pap test once every three years, and women over 30 have a Pap smear and HPV test (the HPV virus is a common cause of cervical cancer) every five years.
But some experts believe that new research may tweak those guidelines further: Results from a clinical trial published today in JAMA found that the Pap smear was less effective than an HPV test in picking up on abnormal cervical cells. The study followed more than 19,000 women as they received regular cervical cancer screenings over the course of four years, half through Pap smears and the other half through HPV testing. At the end of their four-year period, all women enrolled in the trial received both types of screening, a practice known as co-testing.
Overall, women in the HPV testing group had abnormal cells caught earlier and more frequently than those in the Pap group, who served as the control. According to the Washington Post, some doctors believe the study can be used as support for a simplified screening process that drops the Pap altogether:
Kathleen Schmeler, a gynecological oncologist at MD Anderson Cancer Center who was not involved in the study, was enthused about the new results. “It’s fantastic,” she said. “What this shows is that you could potentially do just the HPV test and move toward getting rid of the Pap test.”
But as the Post points out, just because one test may be better than the other doesn’t mean that either alone is better than both together: The study authors explained that while the HPV test picked up on 25 abnormal results that the Pap would have missed, the Pap also found three cases that would have gone undetected by the HPV test alone, suggesting that co-testing is still a safer screening method than either procedure on its own.
And practically speaking, from the patient’s perspective, dropping the Pap smear wouldn’t change much: Like the pap, the HPV test involves swabbing cervical cells, so this isn’t a question of replacing one procedure with another, less invasive one. The practical implications of this study remain to be seen, then, but one thing remains as clear as ever: The best cervical cancer prevention is still the HPV vaccine.
