The debate about cervical cancer testing continues

(BPT) - While research shows that women and healthcare providers agree that the Pap test should remain an element of frontline cervical cancer screening, debate continues within the healthcare community around the most effective way to screen for cervical cancer. In the meantime, the debate has led to confusion and concern among women and healthcare providers who have come to see the Pap test as central to the well-woman’s visit.

The truth is, the rate of cervical cancer, which had been a leading cause of death among women, has fallen by more than 70 percent since the Pap test became standard practice starting in the 1950s. Today, however, our understanding of the disease also includes the role of the human papillomavirus (HPV), some strains of which can cause cervical cancer. As a result, experts currently are debating how to use the Pap test and the HPV test to protect women from cervical cancer. The current consensus guidelines, which were updated in 2012, recommend Pap-only testing for women ages 21 to 29 and co-testing with Pap and HPV tests together for women ages 30 to 65.

Most women and healthcare providers believe Pap-plus-HPV testing best protects women’s health. A recent survey commissioned by the National Association of Nurse Practitioners in Women's Health (NPWH) and HealthyWomen (HW) shows that women and healthcare providers overwhelmingly prefer continued use of the Pap test as part of frontline screening.

The survey, "Cervical Cancer Today: A National Survey of Attitudes and Behaviors," also found that co-testing with Pap and HPV tests has been widely adopted by healthcare providers, especially nurse practitioners and OB-GYNs, 83 percent of whom say it adds value to their patients’ health. In fact, a study newly published in a peer-reviewed journal of the American Cancer Society examining results from more than 8 million women, of which 256,648 women received a biopsy and 526 had confirmed cases of cervical cancer, showed Pap-plus-HPV testing to be the best screening strategy to detect cervical cancer in women aged 30-65.

"The Pap and HPV tests each contribute useful and distinct information for evaluating cervical cancer risk," says Gay Johnson, CEO of NPWH. "Current practices and the preferences of women and their healthcare providers should be considered when discussing and evolving guidelines for cervical cancer screening."

"Cervical Cancer Today" also found that the idea of extending testing intervals to three or five years triggers deep concerns for both women and their healthcare providers. Contributing to this concern and overall confusion about how to screen, may be the lack of understanding among women around HPV. The reality is that nearly 80 percent of sexually active women will become infected with HPV at some point in their lives, and the huge majority of these infections will clear up on their own – a fact only 15 percent of women surveyed understood. In some cases, HPV infection can cause health problems like genital warts, cervical cancer, or cancer of the throat, according to the CDC. However, HPV can be effectively monitored and, while rare, if it progresses to pre-cancer, treatment can help to prevent cancer.

"There has been a lot of information presented about HPV and cervical cancer, making it difficult for women to make informed decisions about their screening options," says Registered Nurse Beth Battaglino, president and CEO of HealthyWomen. "Women need to be having these important discussions about screening – and the meaning of both HPV and Pap tests – with their healthcare provider to determine the best approach for their individual health needs."

To learn more about Cervical Cancer Today, visit www.npwh.org or www.healthywomen.org.