VIDEO: Should the HPV test be a stand-alone cancer screening test?

WASHINGTON – Despite being approved by the Food and Drug Administration as a primary cervical cancer screening test starting at age 25, most medical societies recommend that the human papillomavirus (HPV) test be used as part of a cotesting strategy with cytology, and only among women age 30 years and older.

At the annual meeting of the American College of Obstetricians and Gynecologists, physicians debated whether the HPV test was ready to replace the pap smear as the standard primary screening test for cervical cancer.

Dr. Warner K. Huh, professor and director of gynecologic oncology at the University of Alabama at Birmingham, said in a video interview that the HPV test has already clearly been shown to be superior to cytology, which has a low sensitivity and is highly subjective. There also is a minimal difference between the sensitivity of HPV testing alone versus the combination of the HPV test and cytology, he added.

Although most physicians may not yet be ready to use the HPV test alone, Dr. Huh said that he sees the medical community gradually moving in that direction.

But Dr. George Sawaya, professor in obstetrics, gynecology, and reproductive sciences and epidemiology and biostatistics at the University of California, San Francisco, said in a video interview that he’s concerned that the use of the HPV test alone will result in women undergoing further testing – including cytology and colposcopy – and long-term monitoring. He added that any type of screening is valuable and that the key to decreasing cervical cancer cases and deaths is to reach those women who have never been screened.

mschneider@frontlinemedcom.com

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