Dr. Marie’s HEALTHY DOSE of WHY THE PAP TEST IS NOT ENOUGH

A recent article in the British Medical Journal, LANCET, found that there may be a smarter way to check for abnormal cell changes and cervical cancer than getting just a PAP TEST.  The researchers found that testing women ages 30 and over with the DNA HPV test (the test which checks for the virus, HPV, that causes cervical cancer) was actually better than testing with the Pap test.  The DNA HPV test led to the discovery of more women with abnormal cells needing treatment and provided greater peace of mind.  The DNA HPV test was so good that the authors suggested the possibility that women could be tested less often as a result.  That sounds like great news to me!

This article reminds me however that many women still don’t understand exactly what the Pap test is all about – nor do they even know there is another test available to check for cervical cancer called the DNA HPV test or THE HPV TEST.  I thought I would share with you my responses to some questions I was recently asked for an upcoming article in a women’s magazine.  I promise to share the article as soon as it is published.  To learn more about cervical cancer, you can visit my website at http://www.drsavard.com/cancer/cancer_home.html.

Question:  Why are we telling people to have THE HPV TEST (the DNA HPV test) now? 

My Answer:  Although the FDA approved the use of the HPV test along with the Pap test in women 30 and over in 2003, most women know very little about what the Pap test is for, and have no idea that a simple test called THE HPV TEST could be done at the same time as the Pap test to check for the cause of cervical cancer.  Most women assume their doctors are giving them the most up-to-date testing when they go for the Pap and do not know they may need to ask.  Yet many doctors I have found are hesitant to bring up the subject with women as they have so little time to provide the education women need.  So although we know that the Pap test can miss abnormal cell changes 15 to 50% of the time and a negative HPV test is virtually 100% peace of mind, all doctors do not routinely offer women both tests. It was not until the huge ad campaign for the vaccine Gardasil that mothers and daughters started learning more about this HPV/virus that affects most of us at some point in our lives.  As women learn more, they ask questions and now for first time realize they need to talk to their docs about the test for a virus they may have acquired many years earlier - to be sure it was still not dormant in their bodies putting them at future risk of cancer or serious cell changes. 

Question:  Is HPV directly linked to cervical cancer?

My Answer: YES.  ONE OF 15 HIGH RISK STRAINS OF HPV IS THE NECESSARY CAUSE OF CERVICAL CANCER.  So with even one partner - it is possible to acquire HPV at some time.  For most women the HPV goes away when the body’s immune system kicks in to fight it off – but for 5-10% of women the virus doesn’t clear up on its own and can therefore cause cell changes and even cancer many years later.  The HPV TEST checks for the high risk strains of the HPV that can cause cancer to find the few women that didn’t fight off the virus on their own.

Question:  Why are women not having the test? 

My Answer:  Every woman I have spoken too wants to ask for the HPV test along with the PAP test at their next visit once they understand the link between HPV and cervical cancer.  Women understand that if they are already at risk and having an annual Pap test, adding the more sensitive and reassuring test will give tremendous peace of mind.  But it is important to remember - you need to ask your doctor to be sure she is doing it if you are 30 and over (younger women don’t need to be tested routinely because there bodies may not yet have fought off the virus and therefore a positive result would simply mean waiting a year or so to recheck as the virus should go away on its own).   

Question:  Do you usually have to bring the HPV test up with your doctor? 

My Answer:  Although more and more doctors are now doing both the HPV test and the Pap test at the same time in women 30 and over - don’t take it for granted.  Better to ask – the very same sample of cells from the Pap test can be used to test for HPV.  Better to ask before the exam to have the two together than having to make a return appointment if you forget to ask.  Also, don’t forget to ask for copy of your Pap test and HPV test results.   HINT:  Give your doctor a SASE/self-addressed stamped envelope…just to be sure your results don’t fall through the cracks, as “no news on test results is NO NEWS”. 

Question:  And to be clear–you should get this every time you have a Pap? 

My Answer:   IF you have the HPV test and Pap test as a routine for women ages 30 and over AND you are one of the lucky 90% of women who will test negative on both - then the test combination is SO GOOD THAT YOU DON’T need either a Pap or an HPV test for another three years.  Doctors however worry that some women may not come back for an annual check of everything else – including a check of their breasts, pelvic exam to check the ovaries, a rectal exam and stool for blood check, blood pressure check, etc.  But I think women are smarter than that and know there are many things that need to be checked besides a Pap test every year.  Women who test positive for the HPV/virus should continue yearly Pap and HPV check-ups, and their doctors can take extra measures to ensure that any possible cervical cell changes are caught early, before they turn into cancer. It’s as simple as that. You deserve to know everything about your health, so ask your doctor for an HPV test at your next gynecologic exam.  To learn more about cervical cancer and HPV, visit http://www.drsavard.com/cancer/cancer_home.html.

As always, I welcome your questions and comments.

Warm regards, 

Dr. Marie


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