Testing for Cervical Cancer

Testing for cervical cancer has been a hot button topic in the medical community. There has been serious debate within among experts about how to best screen for cervical cancer in women… i.e. with a pap smear, an HPV test, or both. New results from a recent study showed using both tests together proved to be most effective. In fact, the study found 1 in 5 women with cervical cancer were missed by screening with HPV alone. I interviewed the co-author of the study, Dr. Marshall Austin, to learn more. Here’s the interview


Testing for Cervical Cancer

Lisa LaGrou of Oakland County Moms – Tell us more about your study and what you have found to be the most effective testing for cervical cancer?

Dr. Marshall Austin from the Magee-Womens Hospital – I was very fortunate to be a co-author on this study with Quest Diagnostics, one of the largest commercial laboratories in the United States and we had access to a huge database of over 8 million women screened across the United States for cervical cancer. We had access to data from hundreds of women who actually did develop cervical cancer and we had the opportunity to study the different screening tests and how they performed the pap smear and the HPV test. And, the big finding, the important message for your women viewers was the observation that the highest level of protection was when the women had access to both the pap smear and the HPV test together. The pap smear has been the most efffective cancer screening test in medical history, it has lowered cervical cancer incidents and death rates from being the highest cause of cancer in women to becoming a rare cancer since it was introduced after World War II. But the good news is now with this preferred option of pap testing and HPV testing together, the level of protection that can be offered is even higher than it is with either one test alone. Our studies showed, for example, if we relied only on the HPV test, that we would have a misleading false negative result in nearly 1 in 5 women developing cervical cancer. So the highest level of protection we know is with the pap smear and HPV testing together.

Lisa LaGrou of Oakland County Moms – How is an HPV test performed?

Dr. Marshall Austin from the Magee-Womens Hospital – The HPV test is a test for the virus which causes cervical cancer. This can be tested for from the same collection vial into which the doctor collects the cells for the pap smear. The pap smear, in contrast, is a direct visual exam in which we look at the cells under the microscope and can often see directly the development of cervical cancer. The two tests are complementary – neither test alone is perfect. The highest level of protection we know from the Quest study is when women have both the pap test and the HPV test together.

Lisa LaGrou of Oakland County Moms – Do insurances cover getting both tests done?

Dr. Marshall Austin from the Magee-Womens Hospital – Generally they do because this is recommended as the preferred option in American Cancer Society guidelines. So, most insurances will cover this testing.

Lisa LaGrou of Oakland County Moms – How do you communicate with your doctor that this is how you want your cervical cancer screening done?

Dr. Marshall Austin from the Magee-Womens Hospital – Most doctors’ offices will now offer this test routinely, but not all do offer it routinely so I suggest to women that when they go in for their periodic screening, they specifically ask “Can I have this new, preferred, best option for cervical screening – the pap test and the HPV test together?”


Dr. R. Marshall Austin is Medical Director of Cytopathology and pathologist in Gynecologic and Breast Surgical Pathology at Magee‐Womens Hospital in Pittsburgh, one of the country’s largest academic hospitals. Austin recently co‐authored the largest, real‐world retrospective study of cervical cancer screening strategies, analyzing approximately 8.6 million women.

For more info on testing for cervical cancer, contact your physician.

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