PAP smears have dramatically reduced the occurrence of cervical cancerby
early identification of a pre-cancerous stage. This allows the opportunity
to perform office treatments to remove them, thus preventing progression
to invasive cancer. Despite this accomplishment, PAP smears have always
been less than ideal.
HPV is responsible for inducing the development of cervical cancer as well
as warts. It is acquired through intimate skin contact and studies reveal
that 80% of adults have contracted this virus. Fortunately the immune
system clears the virus in most individuals. In others, HPV persists and
slowly changes the cells of the lower genital track.
Adding a high-risk HPV test to a PAP smear enhances accuracy. For instance,
if both tests are negative it reassures us that there is a greater than
99% chance that any pre-cancerous condition is absent. If HPV is present
it reminds us to remain vigilant with our screening, and depending on
the PAP smear results move on to investigate with a colposcopy exam (magnified
view of cervix and possible biopsy).
The evidence is so compelling that the American Cancer Society and the
American College of Obstetricians & Gynecologists, as well as other
professional societies now recommend HPV screening for women over 30.
Finally, what’s truly exciting is the upcoming HPV vaccine that
will be available later this year to prevent infection and its consequences.
A PAP combined with a negative HPV test predicts with greater than 99%
accuracy the absence of cervical cancer or it’s precursors!