A Food and Drug Administration (FDA) panel has recommended that a DNA test should be the primary screening tool for cervical cancer, rather than the traditional Pap smear. The DNA test detects the DNA of human papillomavirus (HPV), the sexually transmitted infection that causes almost all cases of cervical cancer.
“This is an important step forward for cervical cancer screening,” says Alexi Wright, MD, MPH, a medical oncologist in the Susan F. Smith Center for Women’s Cancers at Dana-Farber. Specifically, the DNA test screens for HPV-16 and HPV-18, the two highest-risk HPV strains, as well as 12 other high-risk HPV types, using a blood sample.
“We’ve known for a long time that Pap smears are important, but imperfect, tests,” says Wright. “Although widespread screening with Pap smears has saved thousands of lives, Pap smears have high rates of false negative results.”
In the ATHENA study, a large trial of 47,000 women who received both Pap smears and HPV blood tests, nearly one in seven of women who were infected with HPV-16 and had normal Pap smears were found to have high-grade cervical disease that was missed on the Pap smear.
“The HPV test is non-invasive and far more accurate at identifying women who are at risk for developing cervical dysplasia and ultimately cancer,” Wright said. “We will recommend the HPV test for regular screening, if it is approved by the FDA. The fact that the HPV test does not require a vaginal exam may mean that more women will choose to get screened.”
“It’s important, however,” Wright cautioned “that physicians don’t abandon vaginal exams entirely since women can develop other conditions, from yeast infections to vulvar cancers, that might go untreated without exams.”