Replacing the Pap Test With Screening Based on Human Papillomavirus Assays

Papanicolaou (Pap) testing for cervical cytology has been the essential first step in enormously successful cervical cancer prevention efforts around the world, but that era is ending. Cytology-based screening has led to substantial risk reductions in more developed countries. According to the Ameri...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2018-07, Vol.320 (1), p.35-37
Main Author: Massad, L. Stewart
Format: Article
Language:English
Subjects:
Acetic acid
Cancer
Cancer screening
Cellular biology
Cervical cancer
Cervix
Cytology
Dependence
Developed countries
Early Detection of Cancer
Female
Health risk assessment
Human papillomavirus
Humans
Inspection
Iodine
Lugol's iodine
Mass Screening
Medical screening
Papanicolaou Test
Papillomaviridae
Papillomavirus Infections
Technologists
Uterine Cervical Neoplasms
Vaginal Smears
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Summary:Papanicolaou (Pap) testing for cervical cytology has been the essential first step in enormously successful cervical cancer prevention efforts around the world, but that era is ending. Cytology-based screening has led to substantial risk reductions in more developed countries. According to the American Cancer Society, 13240 new cases of cervical cancer will be diagnosed in the United States in 2018, with 4170 deaths. The limits of Pap testing are well known, especially sub-optimal sensitivity and dependence on fallible human cyto-technologists. Some alternative screening modalities, such as visual inspection after application of acetic acid or Lugol's iodine, are too inaccurate for use in developed countries. The leading candidate to replace Pap testing for cervical cancer screening is testing for human papillomavirus (HPV), the cause of virtually all cervical cancers.
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.2018.7911