Your Sexual Health Update

A Newer, Better Pap Screen

Introduced in the 1940s as a screening test for cervical cancer, the second most common cancer in women, the Pap test has successfully cut death rates from the disease in half in the past 35 years. But it's hardly perfect: In one study, the Pap correctly detected precancerous lesions just 55 percent of the time. Only annual testing increases the potential hit rate; with three successive annual Paps, about 90 percent of cervical cancer cases are detected.

Enter the HPV test. Approved by the FDA in 2003, the test has an accuracy rate of 95 percent. When paired with the Pap, the rate jumps to 100 percent. Right now, the HPV test is approved only as a co-test with the Pap or as a follow-up test when a Pap is inconclusive; but within the next two to five years, it might become the main screening tool, says Eduardo Franco, PhD, director of the division of cancer epidemiology at McGill University in Montreal.

Currently, the HPV test isn't recommended for primary cervical cancer screening in anyone under 30. That's because about 90 percent of younger women with HPV clear the virus with their own immune system before it causes problems, says Mark Einstein, MD, director of clinical research in the division of gynecologic oncology at the Albert Einstein College of Medicine in New York City. Once you're sexually active, your best line of defense is an annual Pap, which helps a doctor keep track of cervical-cell abnormalities.

But around age 30, the odds of HPV turning into cervical cancer increase, so request combining your Pap with an HPV test, which insurance should cover.