Tuesday, March 23, 2010
Cervical cancer test--one or two?
Shari Simms, Good Housekeeping April 2010, writes about the HPV test. Since 70% of cervical cancer is caused by the HPV virus, a test for this is combined with the pap test to give nearly 100% certainty that a woman does not have cervical cancer.
The HPV test has been approved by the FDA and American College of Obstetricians and Gynecologists, along with the American Cancer Society.
There are 100 strains of HPV, which cause various problems, such as warts. But some can cause abnormalities in the lining of the cervix that years later can become cancerous. Two of these strains—16 and 18—are thought to account for 70% of cervical cancers.
One study of 131K women in India showed that a single HPV test performed 15 to 20 years after becoming sexually active will detect precancers while not promoting overtreatment.
The pap test slashed cervical cancer rates 70%. But it has a lot of false positives and can miss pre-cancers. Tissue changes happen all the time and go away—but they can show up on the pap.
Most doctors don’t think you need a yearly pap if you’ve had three normal ones in a row. You can go every 2-3 years, they say, if you don’t smoke or have a family history.
If you get both the pap and HPV, going three yrs is fine.
What if you get a positive HPV? Well, it doesn’t mean you have cancer or pre-cancer. There is a test for the two “bad” strains of HPV, but it’s not widely available. Your doctor may want to wait and see before physically cutting out a sample—colposcopy.
Why don’t most doctors use this HPV test? It costs $100 and most states don’t require insurance to pay.
Still, there is now some evidence that the HPV can sort of re-emerge and give you an active infection after many years of sexual inactivity.
Oh, lovely. Always something isn’t it.