The FDA Has Approved the New Guidance
HPV Testing For Cervical Cancer but the Doctors are Not Convinced
Women are advised to
undergo two screenings for cervical cancers. The recommendations made by two
medical organizations is first to undergo the human papillomavirus (HPV)
screening before using the Pap smear or Papanicolau screening.
However, all major medical
organizations does not accept or believe
the new guidance. The document containing the instructions is available
nonetheless for doctors who are interested in performing the HPV test for screening
according to the lead author Dr. Warner Huh, from the Society of Gynecological
Oncology and the American Society for Colposcopy and Cervical Pathology
The U.S. Food and Drug
Administration has given its go signal for the use of the HPV test. Huh said
that there’s more important aspect in the testing than obtaining the FDA
approval and it “is getting accurate information to providers so they can
understand the approach,”
According to the Centers
for Disease Control and Prevention that in 2010, approximately 12.ooo American
women suffered from cervical cancer and around 4,000 died from it.
HPV is believed
responsible of more or less 91 percent of cervical cancers.
Currently testing for both
HPV test and the Pap test is done involving the same procedure. Cells from the
vagina and cervix are scraped and sent for lab testing. While the Pap test is
done to confirm the presence of pre-cancerous cells, the HPV test, is performed
mainly to seek out the existence of the virus.
According to a report, a
research study last summer revealed that HPV test is more accurate at
diagnosing the presence of cervix cancer in women compared to the Pap test.
The probability of women
developing cervical cancer three years after testing negative using the HVP
test, according to the study, is much less than a negative Pap test.
Upon reaching the age of
25, women should undergo the HPV test. If the result proves negative there’s no
need to perform another test for the next three years. This is what the new
guidance suggests which is in accordance on the analysis done on 11 researches.
If during the HPV test,
the results show signs of HPV strains 16 and 18, which are responsible for 70%
of cervical cancer, it would be expedient to submit for a cervical biopsy
immediately.
In cases where the test is
positive for HPV strains other than 16 and 18, the women should, according to
the guidance, undergo as Pap test. A published report can be read in
Gynecological Oncology and in two other medical journals.
The new guidance further
suggests that the prevailing Pap testing recommendation should be followed for
women who are below 25 years of age.
Government approved U.S.
Preventive Services Task Force (USPSTF) made a recommendation in 2012, that
women who are between 21 and 65 years old should be screened every 3 years
using the Pap test. Another recommendation for women between 30 to 65 years old
suggested they could choose a combination of Pap and HPV testing to be
performed every five years.
Although the American
College of Obstetricians and Gynecologists (ACOG) had a one of its members
working among the new guidance authors, ACOG still believes in the existing
recommendation which is similar to that of the USPSTF.
There would be many
unnecessary testing in the part of women under 20’s, which is one of the
primary consideration according to Huh, using the HPV test since its common for
this age group to test positive for this particular virus strain.
With almost 79 million
people infected by it, HPV remains as the number one sexually transmitted
disease that affects both men and women. Most of the victims are unaware of it
because the symptoms are relatively unfamiliar and they are self-limiting.
“We think the balance of
procedures and diseases are justifiable,” said Huh, who is also an expert on
gynecologic oncology at the University of Alabama in Birmingham.
Dr. George Sawaya and
Miriam Kuppermann wrote and editorial published in Obstetrics and Gynecology.
They discussed the probable dangers that HPV screening can cause apart from
additional testing.
“Such surveillance recently has been found to
be associated with significant psychological distress in 39 percent of women,”
they write.
Also expressing his
concern about of HPV testing among
younger women is Dr. Brent DuBeshter, director of gynecologic oncology at the
University of Rochester Medical Center in New York.
“Because it’s so common
and disease is so uncommon in that age range, you wouldn’t think it’s a very
good age range for that,” said DuBeshter, who wasn’t involved in the new
guidance.
In his opinion, DuBeshter
added, “HPV testing will eventually overtake Pap tests for cervical cancer
screening, but it’s hard to know when, because change in medical practice is
usually slow”.
Huh said a HPV test costs
roughly $48. That is comparable to a Pap test, according to DuBeshter.
The cost of one HVP test
is estimated at $48 Hu said. The Bashter added that it is similar to Pap test
Huh explained that
together with biopsy, there are at present three means by which women can
undergo cervical cancer testing. He underlined the importance for women to
submit to screening.
“These options become
completely irrelevant if women don’t come into to be screened,” Huh said.
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