Pap tests are one of the most familiar — and successful — cancer screening tests ever invented. Since their introduction in the 1950s, cervical cancer deaths in the US have fallen by more than 60 percent.
But now, a growing number of scientists say, the Pap may be past its prime.
In its place, they are calling for a simple test, one that's already routinely used as a second-line test around the world: screening for human papillomavirus (HPV).
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When the Pap was invented, no one knew what caused cervical cancer. But in the years since, we've come to understand that HPV causes almost all cases of cervical cancer, and vaccinating against the virus can essentially obliterate it.
So, testing for HPV would be an upstream way of testing for cervical cancer risk — allowing for earlier detection, cost savings, and even opening the door for at-home testing.
There are signs it's catching on. Last year, the Netherlands wholesale switched from Pap tests to HPV tests, and Australia is set to follow in its footsteps this year. The journal Preventive Medicine devoted an entire issue to HPV testing in February. Clinical trials of at-home HPV testing are underway across the US, Europe, and Canada.
But some physicians fear the test isn't good enough to replace the monolithic Pap smear — or feel that, even if it is, we shouldn't fix what isn't broken.