Will Cutting-Edge Technology Render Pap Smears a Thing of the Past?
It’s surprising to realize that less than 100 years ago, cervical cancer was the leading cause of death for women. This changed thanks to Dr. George Papanicolaou, who dedicated his life to finding ways to detect reproductive cancer in women. His first research subject was his wife, Mary, and his studies led to the development of the Pap smear. This test allowed doctors to screen cervical cells for precancerous and cancerous growths and became widely adopted by gynecologists across the United States by the 1940s.
The Pap smear has saved tens of thousands of lives and remains an essential tool for cervical cancer screening. Nowadays, some scientists are suggesting an alternative test called the Cobas HPV test, which screens for the human papillomavirus (HPV), the virus responsible for about 90 percent of cervical cancer cases. While the new test has its limitations, it offers another important option for women to monitor their cervical health.
### What Is HPV and How Is It Transmitted?
HPV is mostly spread through vaginal or anal intercourse, but it can also be transmitted during oral sex. Almost all sexually active individuals will have HPV at some point. In some people, HPV causes genital warts, while in others, it can lead to various cancers, including cervical cancer and cancers of the penis, vagina, vulva, anus, and even the throat.
Due to the prevalence of HPV, gynecologists around the world recommend regular Pap smears as part of a woman’s annual checkup. A few years ago, the HPV vaccine Gardasil was introduced and has proven effective in preventing many HPV infections when administered to young men and women. Cervical cancer remains the second most common cause of death among women worldwide, making regular Pap smears critical for early detection and prevention.
### The Cobas HPV Test
The Cobas HPV test can detect DNA from 14 types of HPV, including HPV-16 and HPV-18, which are most commonly associated with cervical cancer. The FDA currently recommends the following process:
– **Test Cervical Cells**: Doctors use the test to check a patient’s cervical cells for HPV. Although the testing method differs from the Pap smear, it still requires a cell sample.
– **Colposcopy**: If a woman tests positive for HPV-16 or HPV-18, she should have a follow-up colposcopy to examine the cervical cells more closely. This is recommended because these two strains cause around 70 percent of cervical cancer cases.
– **Pap Tests**: For those who test positive for other types of HPV, a follow-up Pap test is needed to determine if further investigation, like a colposcopy, is required.
### Concerns About Younger Patients
The FDA has noted that research on the effectiveness of the Cobas HPV test mostly involved women over the age of 25. However, young women aged 25 to 29 test positive for HPV almost twice as often as older women, yet were underrepresented in the study. Moreover, while this younger age group is more likely to carry HPV, they are less likely to develop cancer. Some doctors worry that these women might receive false positives, leading to unnecessary procedures like cervical biopsies, which can weaken cervical tissue and increase the risk of early labor or miscarriage.
Currently, both the Cobas HPV test and Pap tests can be done using the same cervical swab. Combining these tests can help avoid unnecessary follow-up procedures. For example, a positive Cobas HPV test with a negative Pap test suggests no immediate follow-up is necessary, while a negative Cobas HPV test with a positive Pap test indicates the need for further examination.
Though the speculum isn’t going anywhere soon, women should consult their doctors about how using both the Cobas HPV test and Pap tests can best protect them from cervical cancer.
