Are American women really accessing the best cervical cancer screening program?

On I-95 at mile marker 176.2 in the County of Fairfax, motorists can expect potential delays due to a disabled vehicle. The north right shoulder is closed.

Worldwide, cervical cancer remains as a major killer. But, for those of us who live in developed countries it’s barely an issue. Thanks to the introduction of ‘pap smears’ as part of the cervical cancer screening program, clinicians are able to catch cervical cancer before the cells become malignant, giving them the strongest chance of reducing its spread.

Arguably, the continuation of Pap smears is the best way to prevent cancer deaths. At present women aged between 21 and 65 will receive a Pap smear invite each year. As a result, the CDC states that fewer than eight women per 100,000 receive a full cervical cancer diagnosis. In contrast, the WHO estimates that over 14,000 women in Nigeria died from the disease in 2008.

While those statistics may make it seem as though our approach to cervical cancer screening is second-to-none, there have been a few moves towards a better system elsewhere. Primary HR-HPV testing is more likely to detect Cervical Intraepethelial Neoplasia (CIN) than cytology alone. What are the benefits of detecting CIN? At the CIN phase, the cervix is experiencing pre-cancerous cellular changes that are incredibly simple to treat.

What is HR-HPV?

Most forms of cervical cancer arise from the Human Papilloma Virus. Alongside causing warts, chicken pox, and a host of other everyday diseases, it can develop into STDs that increase a woman’s risk of cervical cancer. HPV is surprisingly common, and some of its strains are responsible for thousands of deaths worldwide. 

HR-HPV detects the strains of HPV that cause cervical cancer, and it is highly sensitive in detecting CIN at its earliest stages. As such, it has the potential to detect pre-cancerous changes earlier than the primary cytology approach most clinicians use.

What are the benefits of using HR-HPV?

Although cervical cancer grows at a much slower rate than other forms, tackling it earlier enhances the efficacy of treatment. Even better still, clinicians can paint a picture of a woman’s risk, allowing them to tailor the way they approach their care. 

Other key benefits of HR-HPV include:

  • The false negative rate is much lower, which means attending fewer cervical screening appointments.
  • A greater degree of sensitivity, which means fewer women receiving an incorrect ‘all-clear’ diagnosis.
  • Overall, adopting this more modern approach could save thousands of lives.

If our current cervical cancer screening processes are so effective, why rock the boat?

There’s no denying that our current approach to cervical cancer is astounding. Few women die, especially in contrast with breast and colon cancer. If men were to see the same benefits with a prostate cancer screening program, there would be fewer unnecessary deaths on that front too.

While HR-HPV looks as though it would make moderate changes, when you dig a little deeper such alterations will have a significant impact over the course of a decade. As we move between generations, the use of the HPV vaccine and early CIN changes using HR-HPV could move the screening world into a new frontier.

As long as a better alternative to the current Pap smear program exists, American women are receiving a sub-par service. For now, countries such as the UK and Australia continue to trial the program, which may reveal the extent of the benefits other countries are missing out on.


About the Author

Laura McKeever
Laura has been a freelance medical writer for eight years. With a BSc in Medical Sciences and an MSc in Physician Assistant Studies, she complements her passion for medical news with real-life experiences. Laura’s most significant experience included writing for international pharmaceutical brands, including GSK.