On 2014 Oct 08, David Keller commented:

Screening the Pap smear plus HPV status in parallel improves overall sensitivity

Dr. Feldman's recommendation to continue screening with the Pap test makes sense; the Pap smear directly detects malignancy and worrisome pre-cancerous cellular changes. High-risk HPV is an infection which can cause cervical cancer, but testing for HPV does not provide direct evidence of the presence or absence of cervical cancer and its precursor lesions. Women die of cervical cancer, they do not die from HPV infection. The HPV test and the Pap test provide complementary information, there is unique information learned from each test when they are both performed, and screening sensitivity is enhanced when 2 such tests are performed in parallel (1). Screening women for cervical cancer without any examination of cervical cytology does not seem prudent at this time.

Reference

1: Fletcher RH, Fletcher SW. Clinical Epidemiology: The Essentials Lippincott Williams & Wilkins, 2005: 4th ed

On 2014 Oct 08, David Keller commented:

Screening the Pap smear plus HPV status in parallel improves overall sensitivity

Dr. Feldman's recommendation to continue screening with the Pap test makes sense; the Pap smear directly detects malignancy and worrisome pre-cancerous cellular changes. High-risk HPV is an infection which can cause cervical cancer, but testing for HPV does not provide direct evidence of the presence or absence of cervical cancer and its precursor lesions. Women die of cervical cancer, they do not die from HPV infection. The HPV test and the Pap test provide complementary information, there is unique information learned from each test when they are both performed, and screening sensitivity is enhanced when 2 such tests are performed in parallel (1). Screening women for cervical cancer without any examination of cervical cytology does not seem prudent at this time.

Reference

1: Fletcher RH, Fletcher SW. Clinical Epidemiology: The Essentials Lippincott Williams & Wilkins, 2005: 4th ed