New pap smear tests perform no better than conventional tests

New cervical smear tests are unreliable and should not replace conventional tests (PAP smears) according to a study in this week’s British Medical Journal. Researchers in France studied 828 women referred to hospital because abnormalities had been detected on previous smears and 1,757 women attending for routine smears.
Each woman underwent a conventional cervical smear test. The remaining material was then tested using two new methods (monolayer cytology and human papillomavirus testing). These tests are replacing conventional smear tests in several countries. From the BMJ-British Medical Journal :
New cervical smear tests perform no better than conventional tests

Cross sectional study of conventional cervical smear, monolayer ctology, and human papillomavirus DNA testing for cervical cancer screening BMJ Volume 326, pp 733-6

New cervical smear tests are unreliable and should not replace conventional tests (PAP smears) according to a study in this week’s BMJ.

Researchers in France studied 828 women referred to hospital because abnormalities had been detected on previous smears and 1,757 women attending for routine smears.

Each woman underwent a conventional cervical smear test. The remaining material was then tested using two new methods (monolayer cytology and human papillomavirus testing). These tests are replacing conventional smear tests in several countries.

Conventional cervical smear tests were more often satisfactory and had consistently better sensitivity and specificity than monolayer cytology. Human papillomavirus testing performed no better than conventional smear tests.

These results support the superiority of conventional smear testing, and have implications for regulation of medical devices, clinical practice, and future research on screening for cervical cancer, say the authors. They also emphasise the need to improve the “hard evidence” in studies of new technologies.

Monolayer testing is less reliable and more expensive and should not replace conventional smear tests for cervical cancer screening, while human papillomavirus testing should be further evaluated, they conclude.

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