Study Confirms Longer Time OK Between Pap Tests

Women 30 and older who have normal results on two previous Pap tests can wait three years before their next one.

Although this recommendation is already part of some current guidelines on cervical cancer, not all health care providers follow it. Instead, they give a yearly Pap test even to women who have had several normal tests.

The Pap test screens for cervical cancer, which is curable if detected early. Because the human papillomavirus (HPV) causes cervical cancer, experts also recommend that women be tested for HPV, preferably at the same time they get a Pap test.

More effective test?

New research confirms the longer time between cervical cancer screenings - and also suggests that the HPV test may eventually replace the Pap test as an initial screening. A study involving more than 330,000 women followed the participants for five years after they received a Pap test, an HPV test, or both.

The estimated five-year risk for developing cervical cancer was 7.5 per 100,000 women in those who had a normal Pap test, versus a much lower 3.8 per 100,000 for women who were negative on the HPV test.

When the two tests were performed together, with both yielding negative results, the estimated risk was 3.2 per 100,000 women, meaning that the HPV test alone is almost as good as the two combined.

Test advantages

One advantage to the HPV test is that it's easier to interpret, says Therese Bevers, M.D., at M.D. Anderson Cancer Center in Houston. "It's kind of like doing a pregnancy test at home. It's positive or negative," she says. The cell sample taken during a Pap test must be looked at in the pathology lab to confirm that it's normal.

But the Pap test would still be important as a follow-up to a positive HPV test. "The Pap test can identify women who have more immediate disease," says lead author Hormuzd Katki, Ph.D., at the National Cancer Institute.

Always talk with your health care provider to find out more information.