NEW YORK, Feb 29 (Reuters Health) -- Testing for the sexually transmitted
human papillomavirus (HPV) -- a virus linked to both genital warts and cervical
cancer -- is not helpful for deciding whether some women with suspicious Pap
smears need treatment, according to new study findings.
Each year in the United States, about 2% of women who have Pap smears to
detect cervical cancer are found to have growths in the cervix called low-grade
squamous intraepithelial lesions.
Even though these lesions disappear on their own from 70% to 80% of the
time, it is not easy to predict which ones will clear up without treatment and
which ones become cancerous. For this reason, many women may have them removed
unnecessarily, which can cost more than $1,000.
Because some types of HPV -- a sexually transmitted virus that can cause
genital warts or be completely symptom-free -- are linked with cervical cancer,
it was thought that HPV testing might determine which women with lesions are
most likely to get cancer.
Unfortunately, HPV testing did not turn out to be much help, according to
Dr. Laura A. Koutsky, of the University of Washington in Seattle, and
colleagues.
When 642 women with the cervical lesions were tested, about 83% tested
positive for strains of HPV linked to cancer, the researchers report in the
March 1st issue of the Journal of the National Cancer Institute. Since most
women tested positive on the HPV test, it did little to help identify which
women had lesions that cleared up without treatment, the authors conclude. The
investigators expected about half of the women to test positive for high-risk
strains of HPV.
However, the HPV test may prove to be important in women from developing
countries, said Koutsky, in an interview with Reuters Health.
In such countries, scarce resources and technology make offering Pap
smears difficult, and the HPV test, which is simpler to perform, may be an
effective way to detect women who are at risk of developing cancer, she said.
Even in developed countries like the United States, the HPV test might turn out
to be an acceptable alternative to Pap smears in older women, according to
Koutsky.
In an accompanying editorial, Dr. Michele Follen, of the University of
Texas M.D. Anderson Cancer Center in Houston, and Dr. Rebecca Richards-Kortum,
of the University of Texas at Austin, point out that the researchers had
expected that only about 50% of the women would test positive on the HPV test.
The results of the study show that this test is not helpful for making treatment
decisions, according to the editorialists, but they do not rule out that a
better test might be developed.
In addition, they agree with Koutsky that the current test may turn out to
be useful in developing countries, where screening for cervical cancer is much
less common than in the United States.
