Although there is no mention of any comparative study, the following info from the Cancer Council of Victoria, currently featured on PAPSCREEN VICTORIA website, may be of interest :
Advances in screening technologies The Pap test was developed in the 1920s by Dr George Papanicolaou and has remained virtually unchanged since then. Although nothing has yet replaced the need for direct examination of the cervix, technological advances are changing the way Pap tests are conducted, prepared and screened.
Despite these advances, it is important to remember that no screening test is 100% accurate. The Pap test is about 90% accurate and is currently the best protection against cervical cancer. PapScreen Victoria does not recommend any product or service other than having a Pap test every two years.
New technology There is insufficient independent evidence to indicate if any of the following technological advances are more effective than the conventional Pap test. Further high quality evidence on the performance of these technologies is needed to determine if they are of equal or superior effectiveness to the conventional Pap test.
PapScreen Victoria's position is that we encourage women to have a Pap test every two years. All women should have equal access to services, and not be disadvantaged by their geographic location or cost. We do not endorse any product or service other than the Pap test, yet we do believe in choice for women.
New ways to look at Pap tests include:
Tam-Pap® Tam-Pap® is a process that allows women to self-sample at home for the human papilloma virus. The name Tam-Pap® is derived from the word Tam pon, which is being used as the collection device, and from Pap illomavirus. Tam-Pap® instructs women to insert a tampon for around 10 seconds and then withdraw it. Tam-Pap® claim that after withdrawal, the tampon will hold adherent cells. The tampon should then be placed in the bag provided and sent by the woman to a recognised pathology service provider. Results are sent to the woman's GP/pap test provider within approximately one week.
Tam-Pap® is limited to marketing to health professionals only. It is not a Pap test, as the name suggests, and does not detect abnormal cells on the cervix which can lead to cervical cancer. Only a Pap test can do this and this product should not be seen as a replacement. For this reason it is important to have a Pap test every two years. Tam-Pap® costs about $50, and no Medicare rebate applies. Monolayer testing (Liquid based cytology—Thinprep and Autocyte PREP)
Monolayer testing is an additional test to the conventional Pap test. The Pap test is taken in the usual way, and in addition to preparing the slide, the sampling instruments are rinsed in a liquid which is also sent to the laboratory. A machine filters the cells from the liquid removing unnecessary material such as blood, bacteria and other matter. The cells are then deposited as a single layer onto a slide. Liquid-based cytology has an additional charge to the woman of approximately $30. There is no Medicare rebate.
Computer assisted rescreening (PAPNET and AutoPap 300 QC) PAPNET is a sophisticated computerised technology used to rescreen the Pap test slide. The Pap test is taken and tested in the conventional way. After the Pap test is examined by the cytologist, the slide is sent to Hong Kong where it is screened by a computerised microscope. Images of the cells are sent back on data tape to be looked at in the laboratory on a dedicated monitor. PAPNET has an additional charge to the woman of approximately $30. There is no Medicare rebate. AutoPap 300 QC is another method of rescreening slides using a computerised microscope. It is not widely available in Victoria.
Optoelectronic screening (TruScreen) TruScreen is used in addition to the conventional Pap test. It examines the cervix with a pen-like wand. The TruScreen wand touches the cervix to pick up electrical and light signals from the tissue beneath which compares them to a databank of cervical tissue types. The health worker is given an immediate result of either ‘normal' or ‘abnormal'. TruScreen is slowly being released onto the Australian market, is not widely available at this stage and the cost to the woman is approximately $35. There is no Medicare rebate.
HPV vaccine A vaccine is now available in Australia to prevent HPV. This vaccine works by immunising young women well before they become sexually active against infection of HPV. At the moment, the vaccine will not protect women who are already sexually active nor does it protect against all types of HPV. While the new vaccine aims to prevent cervical cancer in the next generation, a Pap test is the best prevention for those women currently at risk. Find out more under What is the cervical cancer vaccine?
HPV testing A test for detecting HPV types associated with cervical cancer is available, but is often not helpful in women under the age of 30 for whom these HPV types are very common and usually transient.
However, the NHMRC Guidelines for the Management of Asymptomatic Women with Screen Detected Abnormalities were updated in June 2006, and now recommend that this test is useful for women who have had a biopsy-proven high-grade disease (i.e. CIN2 or CIN3), which has been treated.
Women whose biopsy is reported as high-grade receive ablative or excisional treatment to remove the area of abnormality. Despite apparently successful treatment, published studies show that this group of women remains at a slightly higher risk of cervical cancer than women who have never had an abnormality. Because of this higher risk, these women have until now been recommended to have annual Pap tests for the rest of their lives. Post treatment of a high grade lesion
Women who have received ablative or excisional treatment for a high-grade abnormality should have six tests using three modalities over a two-year interval after the treatment. If these six tests are normal, it is recommended that these women return to the usual screening interval (currently two years). The six tests and three modalities are: • 4 to 6 months after treatment – Pap test and colposcopy • 12 months after treatment – Pap test and HPV test • 24 months after treatment – Pap test and HPV test
Veda-Scope The Veda-Scope is an alternative to the speculum. It is not a new type of Pap test. The advertising claims that it is more comfortable than the traditional duck-bill speculum. It operates by placing the disposable Veda-Scope speculum into the vagina and opening it with light air pressure.
As you would be aware, most women do not find the Pap test unduly uncomfortable, and the advantages of using the Veda-Scope over the traditional speculum are still debatable.
The Veda-Scope is rarely used and is only available from a small number of practitioners. It costs women around $10–15. It cannot be used on those who are pregnant, early post-partum or those who have recently miscarried.
Remember: Veda-Scope is an alternative to the speculum, not an alternative to the Pap test. Print Email Latest News Media kit
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