New HPV Test Sensitive, Specific for Cervical Cancer
HPV test can detect 95 percent of precancerous lesions; cotesting with Pap detects more disease
TUESDAY, June 10, 2014 (HealthDay News) -- The new human papillomavirus (HPV) test has higher sensitivity and specificity than Papanicolaou (Pap) testing for cervical cancer, according to an ideas and opinion piece published online June 9 in the Annals of Internal Medicine.
Noting that the Pap test has a relatively low sensitivity and that results are often poorly reproducible, Rebecca B. Perkins, M.D., and Elizabeth A. Stier, M.D., from the Boston University School of Medicine, discuss the newly approved Cobas HPV test.
The authors found HPV testing to be superior to a single Pap test for detecting cervical precancer and cancer, with higher sensitivity and specificity. A single HPV screen can detect 95 percent of precancerous lesions, compared with 40 to 70 percent for Pap testing alone, they write. Pap testing has a lower negative predictive value than HPV testing, and repeat screens are needed to reduce cervical cancer rates. The authors also note that cotesting with Pap and HPV tests detect more disease than either test alone, with each test missing some cancer cases, but the improvement appears modest. The costs of primary HPV testing versus Pap alone or cotesting have not yet been standardized, and cost-effectiveness will vary based on the value of testing and recommended screening intervals, according to the authors.
"Increasing population coverage with any screening test and ensuring that women are not lost to follow-up with lengthened screening intervals are more important than the choice of test to decrease rates of invasive cervical cancer," Perkins and Stier conclude.