Might women over 30 soon be saying goodbye to the Pap smear? That's what some experts believe after a new study found that the HPV test detects precancerous cervical changes earlier and more accurately. The randomized, controlled study—the Washington Post calls it the "gold standard" of research—looked at 19,000 women over a period of 10 years. One group got the HPV test to screen for cervical cancer, nearly all cases of which are caused by HPV, the most common sexually transmitted infection. The other group was screened using Pap cytology, the liquid-based test that has largely replaced the conventional Pap smear in the US. The HPV test identified significantly more precancerous lesions earlier, and four years after the women were initially screened, they received both an HPV test and a Pap test. Fewer cases of precancer were found in the HPV group, since that group had already had more precancerous signs identified and treated.
But in recent years, most medical groups have been recommending women get both tests, and some experts are pointing out that such so-called "co-testing" may be better than the HPV test alone at detecting precancerous changes; the study did find that in a small number of cases, Pap cytology identified precancerous lesions that HPV testing did not. The US Preventive Services Task Force currently recommends a Pap smear every three years or co-testing every five years for women age 30 and up, but it is considering changing that recommendation to just one test or the other, and this study could speed things along, NPR reports. Pap smears will still be recommended for women under 30, since HPV is so common that many in that age range would test positive for an infection that will end up resolving on its own. Whether medical recommendations change or not, a woman's experience with her doctor definitely won't, NBC News reports, because both both tests are administered via smear in the doctor's office.