Benefits of the HPV test for early detection of cervical cancer are being reviewed
Human papilloma viruses (HPV) are the main trigger for cervical cancer (cervical cancer). Nevertheless, the HPV test is not part of the statutory early detection program, not least because there are doubts about its informative value and it cannot replace the so-called PAP test (special smear test) as a test method, reports the cancer information service of the German Cancer Research Center (DKFZ) in Heidelberg . Women who still want to have an HPV test usually have to pay for it themselves. "Whether the detection of human papillomavirus could not be used sensibly for the early detection of cervical cancer" is currently being examined again, according to the Cancer Information Service.
Some health insurance companies are already paying for an HPV test under certain conditions, although this is not one of the legally required early detection examinations. Mostly, the test is offered by gynecologists as an Individual Health Service (IGeL), for which up to 70 euros are due. In case of doubt, even a positive result says little about the cancer risk. Because HPV infections are not uncommon and they do not necessarily have to lead to cervical cancer. According to experts from the German Society for Gynecology and Obstetrics, the test can still make an important contribution to early cancer detection and prevention under certain conditions. According to the Cancer Information Service, the Institute for Quality and Efficiency in Health Care (IQWiG) has also identified indications that women can benefit from an HPV test as part of early cancer detection. However, no recommendations for a specific investigation strategy can be derived from the available research results.
Positive HPV test alone with little informative value According to the Cancer Information Service, a positive result of the HPV test has "currently no relevance for early detection in healthy women with normal findings in the smear test." Because this does not reveal whether the infection is only temporary is or threaten tissue changes in the long term. Especially for women under the age of 30, the test result is not very meaningful, since "a result that is positive today can be negative shortly afterwards". Infection is also easily possible after the test, so that it does not offer any reliable information. In addition, no immediate therapeutic measures can be derived from the test, since no drugs are known to treat the viruses. It is only possible to treat these if tissue changes actually form. Here, the HPV test can possibly provide important information for early detection and thus make treatment significantly easier. Even after surgery for cervical cancer, regular HPV tests are useful to monitor the success of the treatment.
Health insurance companies pay for the HPV test under certain conditions. Although there is currently no provision for the HPV test to be fully covered by the statutory health insurers, the health insurance companies already bear the costs for the examination under certain conditions. According to the Cancer Information Service, this applies, for example, "if the doctor finds abnormal cells during the examination that cannot be clearly assessed." Here, the test helps "to clarify the findings more precisely and to determine further treatment." The health insurance companies also pay HPV test "for patients who have had surgery for a cervical tumor or pre-cancer," reports the cancer information service. However, the German Society for Gynecology and Obstetrics generally recommends the HPV test for women from the age of 30, as they are at an increased risk that the pathogens remain in the body longer and thus cause cell changes. If the test turns out to be negative, so no pathogens can be detected, the women may have to “no longer annually, but possibly only after two to five years for the next cervical cancer screening,” according to the Cancer Information Service. So far, however, the health insurers have not been able to assume the costs.
Most successful cancer test ever The HPV test may be a useful addition to conventional cervical cancer screening, but the PAP test remains essential as a standard test. "With the help of this simple smear of the cervix and cervix, pathologically altered cells can be found that can develop into pre-cancerous stages," reports the Cancer Information Service. Even if the PAP test shows a noticeable result, cervical cancer does not necessarily have to be present. Inflammation is often the cause of tissue changes. In this case, further examinations must follow in order to arrive at a reliable diagnosis. According to the Cancer Information Service, the Pap test is “the most successful Cancer testof all time. ”However, he also has weaknesses. Sometimes lighter tissue changes are overlooked, which is why the examinations should be repeated regularly. In addition, the test incorrectly yields a positive result in rare cases.
Significant decrease in deaths Overall, the number of cervical cancer deaths has halved in the forty years since the PAP test was introduced. According to the Robert Koch Institute (RKI), 1,524 women died from cervical cancer in 2010. The number of new cases annually is around 4,600 cases. According to the RKI, the death rate has been falling steadily since the 1980s and the “relative 5-year survival rate with invasive cervical cancer is 69 percent.” The increased chance of survival is not only a result of the improved medical options, but also a result of comprehensive screening programs, reports the RKI. (fp)
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