The Pap smear has caused a fivefold drop in cervical cancer since the 1960s. But since a doctor must take the smear during a pelvic exam, women who don’t have access to gynecologists aren’t screened. So a self-collected test could be good news for patients, like the 1,365 South Africans in one of the JAMA studies. They collected their own vaginal samples on swabs. Samples were sent to the United States, where a DNA test caught 66 percent of the women’s cervical cancers; 68 percent were detected by Pap smears. And when doctors collected the samples, that study, and a second one of Costa Rican women, found that DNA tests actually caught more cancers than Pap smears.
Does this mean women can bid farewell to the Pap test? Probably not. Doctors think cervical cancer is caused by the sexually transmitted human papilloma virus. The DNA test detects genetic material from 13 forms of it, which are found in 96 percent of patients who have cervical cancer. But most young women who have papilloma virus don’t actually develop cancer. So the test can cause false alarms.
DNA tests could prove useful for older women, though. Most women fight off the virus before they turn 40. If they don’t, they’re more likely to get cervical cancer. But they’re also less likely to get Pap smears because many stop visiting gynecologists after childbearing age, and the test gets more uncomfortable. So a quick, self-collected test could cut cervical-cancer rates: “If we could make screening as easy as a urine test at the doctor’s office, we would get more coverage,” says Thomas Wright, lead author of the South African study and associate professor of pathology at Columbia. Though true home testing awaits FDA approval and could be years away, general practitioners could administer the test, too.
Detection is one thing; treating cervical cancer is another. Doctors recently announced that a combination of radiation and chemotherapy can cut the risk of death 30 to 50 percent. And researchers hope to someday prevent papilloma infections: “Ultimately, vaccines will be the way we prevent cervical cancer worldwide,” Wright predicts. But for now, the DNA test could help–mainly in countries that can’t afford the $6 billion the United States spends on Pap screening every year. But there’s one important caveat: a new test will be useful only if patients can get medical treatment afterward.
title: “An At Home Lifesaver " ShowToc: true date: “2023-02-01” author: “John Bartley”
That could be good news for patients like the 1,365 South Africans in one JAMA study. Their own samples were sent to the United States, where a DNA test caught 66 percent of the women’s cervical cancers; 68 percent were detected by Pap smears. Detection is one thing; treatment is another. But the DNA test could help in countries that can’t afford the $6 billion America spends on Pap screening every year.
