HPV is associated with almost all cases of cervical cancer, so scientists have been looking into whether testing for HPV infection could be used as a screening test for cervical precancers and early cancers. The two JAMA studies along with an accompanying editorial address that question.

Editorial author Jack Cuzick, PhD, of the department of mathematics, statistics, and epidemiology at the Imperial Cancer Research Fund in London, believes the advantages of HPV testing are its simplicity – samples may be collected by health professionals or by women in their own homes using vaginal swabs – and its potential for use in places where women don't have adequate access to Pap screening.

Robert Smith, PhD, director of cancer screening for the American Cancer Society (ACS), agrees with that assessment. "Both studies showed the sensitivity of the HPV test can approximate that of the Pap smear," Dr. Smith said. "This means the potential for using HPV testing in countries without adequate cervical cytology services, or as an adjunct test in countries with established cervical cytology services, is potentially a viable option."

Disadvantages are that HPV testing produces more false positives (test results implying a condition exists when in fact it does not) than the Pap test and increases the cost of screening – a concern particularly in places where Pap testing is already available. The consequence of false positives is more women would need to undergo colposcopy (viewing the cervix through an instrument that resembles binoculars) and biopsy (removing a small tissue sample).

"More research is necessary to reconcile under what circumstances either of these options would contribute to the primary goal of cervical cancer screening, which is the prevention of invasive disease and death from cervical cancer," Dr. Smith said.

The value of HPV testing is strongly influenced by a woman's age. HPV infection is quite common among young women but most of these infections eventually resolve themselves without treatment and never lead to a cancer or even a high-grade precancer. Among women over 40, however, HPV infection carries a greater risk of eventually leading to cancer.

The value of cervical cancer screening with the Pap test or, potentially, with HPV testing, is precancers and early cancers found by these tests are completely curable. The ACS recommends all women who are or have been sexually active or who are 18 and older have an annual Pap test and pelvic examination. After three or more consecutive negative exams, the test may be done less often.

Unfortunately, many women in the US still do not take advantage of the Pap test. About 70 percent of women newly diagnosed with invasive cervical cancer had not had a Pap test within the past five years.