July 10, 2018

Harper tells NPR that, for women over 30, the HPV test alone may decrease rates of false positives, compared to combined Pap-HPV testing


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Diane Harper, M.D., M.P.H., M.S., professor, was asked by NPR to respond to a recent randomized controlled trial, published in JAMA Oncology, that compared two approaches to screening for the human papillomavirus (HPV).

In her response, Harper praised the study as “extraordinarily well done” and argued for the potential patient benefits of utilizing HPV testing only, compared to a combination approach, which pairs the test with traditional cytology, or Pap smear. Harper states, “The whole reason for [co-testing] is that you get a slight improvement in sensitivity.” She adds, "But your false positive rate blows up. It's up to 30 percent of people [who] are falsely positive."

These false positive cases can lead to unnecessary, higher risk follow-up procedures, like biopsies.  "That's a lot of women that are unnecessarily worried.

Harper heralded the HPV test, adding, “It's really amazing — there's no other test that gives us this level of reassurance for that period of time for a cancer.”

In the HPV FOCAL trial, 19 009 Canadian women, aged 25 to 65, were randomized to either the control group, which received a Pap smear, or the intervention group, which receive HPV testing.  Follow-up testing was done as needed, and both groups were tested again using both methods after four years.

The University of British Columbia researchers found that “the use of primary HPV testing compared with cytology testing resulted in a significantly lower likelihood of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) at 48 months.”

To read more about the study and responses from Dr. Harper and other experts, visit the NPR Health blog page.


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