That's likely because women who tested positive for precancer or abnormal cells at the beginning received additional testing and treatment as necessary, van Niekerk said.
Because health care is a provincial responsibility, it's up to the individual provinces and territories to decide whether to adopt HPV testing instead of Pap testing for cervical cancer screening. Cervical cells for both the Pap and HPV tests can be collected at the same time, during a pelvic exam.
The HPV test found nearly 60 per cent more precancers - or abnormal cells that could potentially become cancerous - during the initial screening than the Pap test, said study co-author Dr. Dirk van Niekerk, a pathologist who is also the medical leader of the cervical cancer screening program at the B.C. Cancer Agency. It adds to a body of research suggesting that HPV testing might be more accurate. "It's an important study", said Jason Wright, a gynecologic oncologist at NewYork-Presbyterian/Columbia University Medical Center who was not involved in the study.
Schmeler says that in the USA, it's been hard to justify replacing the Pap smear with the HPV test because there's not been a head-to-head comparison until now. The test uses a similar technique, but with an easier process of using vaginal swabs, and relies on detecting the HPV virus via DNA.
Cervical cancer screening is essential because almost 13,000 women in the US are diagnosed with cervical cancer annually. About 4,200 women will die of the disease.
The Pap test that has been used for decades as the standard in cervical cancer screening for Canadian women should be replaced by a test that detects high-risk types of human papillomavirus (HPV), a new study says. The US Preventive Services Task Force now recommends a Pap smear every three years or co-testing every five years for women age 30 and up, but it is considering changing that recommendation to just one test or the other, and this study could speed things along, NPR reports. The organization has yet to issue final guidelines.
"A few months ago, when the US task force released draft guidelines to consider only HPV testing, there was lots of controversy", Schmeler told ABC News. The randomized, controlled study-the Washington Post calls it the "gold standard" of research-looked at 19,000 women over a period of 10 years.
Neither method was foolproof.
In most provinces, Pap tests are recommended every three years. Of the women who tested negative on the HPV test only 22 women showed abnormal cells (grade 3 or worse), while from the Pap smear group, 52 women ended up with abnormal cells. He said that although the study confirmed previous research showing that the HPV test is more sensitive than the Pap test, it didn't answer a critical question: Is the HPV test alone better than the HPV test and the Pap smear together, as is current practice? In 2017, the researchers running the study reported that there were significantly more cases of precancerous lesions detected early in the trial among the women in the HPV-tested group, compared with the Pap cytology group.
Approved by the FDA in 2014, the HPV test is a relatively new alternative to Pap smears.
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Even if guidelines do change for women over 30, the Pap smear is still important for women aged 21-29. If the virus persists until their thirties, that's where problems come in.
Moving away from co-testing may not be a good idea, according to Mark Spitzer, an OB-GYN and past president of American Society for Colposcopy and Cervical Pathology.
"In the USA, co-testing is now the recommended gold standard, and neither doctors nor their patients should be willing to give up the added benefit you get from screening with a Pap test and HPV test together", he says.
Because all the women in the study who testing negative for HPV were given Pap smears at the end of the study, the results can't determine how one test alone compares to co-testing.
"At the moment, at most, we may be vaccinating at most 30 to 40 percent of girls". "What this shows is that you could potentially do just the HPV test and move toward getting rid of the Pap test".
False positives in diagnosing diseases are a considerable problem to doctors and patients, as they often result in painful, invasive further testing, unnecessary treatment and fear.
"That's a lot of women that are unnecessarily anxious", she says.
Women can get a clear result from a simple HPV test and those who receive a negative result will be able to trust those results for several years, she says.
Although there could be increased costs associated with sending more patients for additional tests and monitoring after HPV detection, those may be offset by the fact that people may not need to have the initial screening as often, she said.
One caution about the study findings, says Dr. Carol Mangione, a USPSTF task force member and UCLA professor of medicine, is that screening - either kind - is what saves lives.