FDA Approves Pap Test Alternative

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Cervical pap smear test equipment

According to the Washington Post, the Food and Drug Administration (FDA) has approved the first alternative to the Pap test as a primary screening method for cervical cancer, in the face of opposition from some women’s groups and health organizations.

The new test, developed by Roche, detects the DNA of the human papilloma virus, which causes almost all cases of cervical cancer, in a sample taken from the cervix. Pap testing involves examining cervical samples under a microscope to detect abnormalities.

A committee of outside advisers to the F.D.A. unanimously endorsed the Roche test in a meeting last month.

However, a group of 17 consumer, women’s and health associations have opposed these new measures, arguing that the new screening method had not been adequately tested.

“This proposed indication for the HPV test would represent an unprecedented and significant shift in clinical practice that would affect millions of women for the majority of their adult lives,” the coalition said in a letter to the F.D.A. earlier this month.

The letter was organized by the Cancer Prevention and Treatment Fund, a research and patient education organization, and signed by the American Public Health Association, Consumers Union, the National Organization for Women and the women’s health education group Our Bodies Ourselves, among others.

The F.D.A. said, however, that the evidence was sufficient.

“Roche Diagnostics conducted a well-designed study that provided the F.D.A. with a reasonable assurance of the safety and effectiveness when used as a primary screening tool for cervical cancer,” Alberto Gutierrez, the agency official who oversees diagnostic testing, said in a statement.

In a letter he sent on Thursday to the coalition of opponents, Dr. Gutierrez noted that the agency merely decided if a test was safe and effective for its intended use. It is up to medical societies and other organizations to decide whether and how to use the test. The approval does not mandate use of the HPV test, just makes it another option.

The Society of Gynecologic Oncology, in a statement, said it and other organizations feel that HPV testing “will provide doctors one more tool to use in cervical cancer screening,” but also acknowledged that the “approval has raised a number of questions.” It said that it was “extremely unlikely that doctors will stop using the Pap any time soon.”

Roche’s Cobas HPV test and HPV tests sold by other companies have been used until now as a follow-up test to help resolve ambiguous Pap results, or together with Pap testing as a primary screening tool.

The new approval would allow the HPV test to be used alone as an initial screen for women 25 and older. Pap testing would be used only in certain cases as a follow-up test.

Studies have shown that HPV testing can result in detection of more precancerous lesions than Pap testing.

However, the virus test could also conceivably lead to more false alarms because presence of the virus does not necessarily mean cancer. Most young women get infected with HPV after they become sexually active, though in many cases their immune systems can clear the virus.

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