• 4/23/2004
  • Associated Press

A more definitive cervical cancer screening test that helps reduce uncertainty in diagnosing the disease is gaining support from doctors and health insurers. Aetna, the nation’s largest health insurer, on Wednesday became the latest plan to cover the new DNA test that checks for the presence of a virus that studies show causes more than 99 percent of cervical cancers. The test is used when a Pap smear proves inconclusive, which happens about 5 percent of the time. Kaiser Permanente, United Healthcare and most Blue Cross and Blue Shield plans already cover the test for human papillomavirus, or HPV, according to the test’s maker, Digene Corp. of Gaithersburg, Maryland. About 400,000 U.S. women had the HPV test in the past year, a Digene spokeswoman said. If the test shows no sign of HPV, a woman is assured she doesn’t have cancer. If the HPV virus present, there is a greater likelihood the woman has cancer and she is sent for additional testing which most likely include a biopsy. “Aetna is a bellwether for the adoption of HPV testing as a standard of care in cervical cancer screening,” said Evan Jones, Chairman and CEO of Digene Corporation.

About 50 million Pap smears are performed annually in the United States. Before the HPV test was approved by the Food and Drug Administration in 1999, women who had an inconclusive Pap test would have to get another Pap test or an outpatient procedure that would likely include a biopsy. The results of a biopsy could take two weeks, a period in which the woman would not know if she had cancer. An HPV test can be done typically in a lab the same day as a Pap test, and it is done using the same Pap smear. Aetna is working with its clinical labs for them to automatically do the HPV test when the Pap test proves inconclusive, or mildly abnormal. “For the patient this is a tremendous value, because the anxiety of being told you have an abnormal Pap is taken away,” said Dr. Arnold Cohen, Aetna’s medical director for women’s health. Cohen estimated that about 60 percent of HPV tests done after an inconclusive Pap test will show no signs of the virus that causes cervical cancer. Thus, for Aetna and other health insurers, the HPV test eliminates the cost of paying for further office visits and a biopsy. According to the American Cancer Society, an estimated 12,800 cases of cervical cancer will be diagnosed this year and 4,600 women will die of the disease. Some experts say the HPV test can help make sure women are diagnosed earlier when the disease is more easily treated. “This is a real breakthough, a great advance in cervical cancer screening,” said Dr. Mark Schiffman, who is studying the impact of HPV testing at the National Cancer Institute But how widely the screening is used will depend on whether Digene makes the price affordable, especially for public health clinics, he said. The cost for the HPV test to check for cancer is about $50. In comparison, the conventional Pap test costs about $10. Another type of cervical cancer screening test, which was approved in the mid 1990s, is the ThinPrep or Prep Pap test. In those tests, which cost about $30, a computer rather than a laboratory technician scans the Pap smear slide for abnormalities. Studies show this test typically can better identify abnormal cells than the conventional Pap test.