Latino group advises against DNA Pap smear alternative
The National Alliance for Hispanic Health is taking a stand against against a new DNA alternative to the traditional Pap smear. The organization, which has…
A new DNA test seeks to replace the Pap smear as the first screening tool for cervical cancer, but some groups say it might be a bad idea. (Shutterstock)
The National Alliance for Hispanic Health is taking a stand against against a new DNA alternative to the traditional Pap smear.
The organization, which has taken huge steps in advancing Hispanics in the United States, has signed a formal appeal letter to the Food and Drug Administration (FDA) asking the test be reconsidered as a first-choice option for cervical cancer screening.
SEE ALSO: Cervical cancer: A serious concern for Latinas
According to the Alliance, as well as 17 other patient advocacy groups, Pap smear screening has long been a reliable method for cervical cancer detection, and a DNA test, though more technologically advanced, could possibly lead to confusion for patients, higher costs and over treatment.
The new test manufactured by Roche uses DNA to detect the human papillomavirus (HPV), which is responsible for the vast majority of cervical cancer cases. Though this test has been available for a number of years, Roche has asked the FDA to approve it as a first-option for clinicians as opposed to the Pap smear.
Though the procedure may seem easier and less intimidating, especially for young girls, the Alliance and other groups express concern about how general HPV screening is not appropriate because not all girls who have HPV are going to develop cervical cancer. Most sexually active people?boys and girls?will contract HPV at some point during their lives and their body will eliminate the virus within a few months
“Unfortunately, the HPV test by itself isnt very useful because so many young women have HPV that will disappear without any treatment, Diana Zuckerman of the Cancer Prevention and Treatment Fund told the Associated Press. Having an HPV test without also getting a Pap smear to check for problems is going to scare a lot of women who are not developing cervical cancer.
The FDA has declined to comment on the letter at this time, stating the DNA test is still under review and no final decision has yet been made.
HPV and cancer screening
The human papilloma virus (HPV) has long been feared for its ability to cause genital warts, but the more scary side of this virus is that it is the primary cause of cervical cancer. According to the Centers for Disease Control (CDC), almost all cases of cervical cancer care caused by HPV, but the virus is also responsible for 50 percent of vulvar cancers, 65 percent of vaginal cancers, 35 percent of penile cancers, 95 percent of anal cancers, and 60 percent of oropharyngeal cancers.
Because HPV is a very common sexually transmitted illness, screening for the presence of the virus in the past has only indicated an individual may be at an increased risk for certain diseases. Most specific tests, like the Pap smear have been needed to pinpoint abnormal cells, making them a more realistic first-step test.
A normal Pap smear, for example, relieves the fear of cervical cancer even if HPV is present. Though it is beneficial to know HPV status, when it comes to cancer screening, DNA testing is not an accurate enough indication, warn the experts.
The DNA test for HPV is supposed to identify the most virulent strains. (Shutterstock)
Currently, many clinicians practice what is known as “contesting,” a combination of HPV screening and Pap smear testing. Dr. Shefali Patel-Shusterman, a gynecologist based in New Jersey, told Healthline she believes even with FDA approval most doctors will continue to use both methods of cervical cancer detection.
SEE ALSO: Vinegar test can prevent thousands of cervical cancer deaths
“I think in the short term, even if the FDA adopts the recommendation, most gynecologists will continue with contesting, Patel said. This allows us to see who is at risk by being high risk HPV positive, but also allows us to pick up dysplasia and treat those lesions so they do not progress to cervical cancer.”
Ultimately, advocates for the new DNA testing hope it will be specific enough to identify if a woman has one of the strains of HPV considered high-risk for cervical cancer. Then, if women test positive for one of the more virulent HPV strains they can follow up with procedures like the Pap smear.
