FDA Mulls Pap Tests Versus HPV Screenings

PITTSBURGH (KDKA) -- The regularly scheduled pap smear -- for many women, it's a routine part of getting a checkup.

This screening test has markedly decreased the incidence of cervical cancer and death.

"There was a 75 percent reduction in the incidence of cervical cancer with the usage of pap smears from about 1990 on," says Forbes Hospital gynecologist Dr. Mark Rubino.

But for women 25 and older, a newer type of screening could be used instead -- the human papilloma virus, or HPV, test.

"This would represent a radical shift in our thinking," says Dr. Rubino. "The usage of the HPV testing, along with the Pap smear right now seems to be the standard of care."

With a Pap test, the doctor takes cells from the cervix, or opening of the womb, with a spatula. The cells are checked under the microscope for any signs of cancer.

With the HPV test, cervical cells are removed with special brushes and put into fluid. The fluid can then be analyzed for any trace of HPV DNA.

Used together, they can be powerful detectors of the virus, which is directly related to cervical cancer, which kills 4,000 women a year.

But Dr. Rubino wouldn't be comfortable abandoning Pap tests and doing HPV tests alone.

"They're limiting it to the two most virulent strains, strains 16 and 18. Unfortunately, we consider there to be about 15 high risk strains right now. And it wouldn't be checking for those," says Dr. Rubino.

An advisory panel to the Food and Drug Administration is recommending the change. It usually goes along with what the advisory panels say.

The FDA has purview over the test, but how it's used? That's up to the American Cancer Society, the United States Preventative Services Task Force, and the American College of Obstetricians and Gynecologists.

"The recommendations for HPV screening don't start currently until the age of 30," Dr. Rubino points out.

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