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HPV Test a Predictor of Cervical Cancer in Women Over 40

Danish study shows HPV test better than Pap test at predicting neoplasia in women aged 40 to 50

THURSDAY, Nov. 2 (HealthDay News) -- Although the traditional Pap smear is the best screening tool for cervical cancer in younger women, a large Danish study suggests that a human papillomavirus (HPV) test is a better predictor of cervical cancer in women aged 40 to 50, according to a report in the November issue of Cancer Research.

Susanne Kjaer, D.MSc., of the Danish Cancer Society in Copenhagen, and colleagues evaluated 10-year data from 8,656 young women (aged 22 to 32) and 1,578 older women (aged 40 to 50) to determine the proportion who developed cervical pathology.

In those with normal cytology results and a positive high-risk HPV test (Hybrid Capture 2, or HC2), 17.7 percent of younger women and 24.5 percent of older women had abnormal Pap smears in the following five years. The incidence of cervical intraepithelial lesions grade 3 (CIN3) or cancer in 10 years was 13.6 percent in younger women with a positive HC2 test and 21.2 percent in older women.

"Among older women where HPV may be added to general screening, the estimated absolute risk of CIN3 [or greater] in HC2-positive women was higher than 20 percent within 10 years. These results indicate that even a single positive HPV test in cytologically negative women is substantially predictive of high-grade CIN and suggest that HC2 testing can help stratify women into different risk categories," the authors conclude.

One of the study authors is an employee of Digene, maker of the HC2 test.

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