A recent study involving more than 800 patients in a large health care plan found that about one in three women with invasive cervical cancer actually had normal Pap test results. Other research suggests that a single Pap test can miss early signs of cervical cancer up to half the time.
While the Pap test is valuable, it does not always detect cancer cells early, when treatment is easiest and most effective. By the time a routine Pap test detects abnormal cell changes in the cervix, cervical pre-cancer may already be occurring.
As a result, the American Cancer Society and several medical groups now recommend that women between the ages of 30 and 65 be tested for certain types of human papillomavirus (HPV) – the main cause of cervical cancer – along with their Pap test.
Of the more than 100 types of HPV, the most common sexually transmitted infection, most are harmless and are cleared naturally by a person’s immune system. In fact, 70 to 90 percent of sexually active individuals will have some type of HPV at some point in their life. But a few types, known as high-risk HPV, can develop into cancer, sometimes decades after a person has been infected.
The two highest-risk types, HPV 16 and HPV 18, are responsible for two-thirds of all cervical cancer cases. So, if a woman does test positive for HPV, it’s important for her and her doctor to know which HPV type she has, to more fully understand her risk.
Advances in laboratory medicine now allow health care providers to screen women specifically for high-risk HPV types. By ordering a high-risk HPV test along with a Pap test, a doctor can find out more about a woman’s risk for cervical cancer. One test in particular, called the cobas HPV Test, gives health care providers individual results for HPV 16 and HPV 18, along with a grouped result for other high-risk HPV types, all in one test. A Pap and an HPV test can be done using the same sample, so all the information is available from just one office visit.
Coupling an HPV test with a Pap (co-testing) provides so much more valuable information about a woman’s risk for cervical cancer that several medical groups now say that women ages 30 to 65 only need to be co-tested every five years if neither test shows new abnormalities.
Although advances in medicine like HPV testing are enabling doctors to provide better care with less frequent testing, many women are still in the habit of having an annual Pap test, and it may be difficult to get used to the change. But there are still many reasons for women to continue their yearly OB/GYN or family physician wellness visits. Perhaps the most important one is that the goal of an annual exam has always been to do a comprehensive review of a woman’s health.
Even without the need for an annual Pap test, yearly well-woman visits are as important as ever for ovarian, uterine, breast, cardiovascular and sexual health, as well as for colon cancer screening, osteoporosis prevention and immunizations.
For women who are concerned about the cost of a yearly doctor visit, it may be helpful to know that annual well-woman visits and certain preventive care services are required to be covered by many insurance providers without a co-pay or deductible under the Affordable Care Act. For non-grandfathered plans, this applies to any new plan year that begins after August 1, 2012. This coverage requirement extends to HPV testing for women ages 30 to 65 as well.
So there are many good reasons for women to schedule their annual exam if they haven't done so yet. More information about Pap and HPV co-testing and knowing a woman's risk for cervical cancer is available at www.facebook.com/PreventCervicalCancer.