Women pay as cervix test is argued

By FRANCESCA MOLD health reporter

Women fearful of cervical smear misreading have become caught in the middle of a debate over a new test which claims to improve the odds of detecting cancer.

The ThinPrep test is being offered to women as a more accurate alternative to the conventional pap smear.

But smear-takers say they are confused about whether they should promote ThinPrep after an independent review released by the Health Funding Authority this week found it no better than the pap smear, used for more than 50 years.

One doctor said pathologists had encouraged him to supply the new test because it was more accurate.

But he questioned whether there was a commercial incentive behind pathologists' support for the ThinPrep test, which costs an extra $15 to $20.

Up to 500,000 smears are processed in New Zealand each year - about 17 per cent of which are ThinPrep.

Society of Cytopathologists president Dr Tony Bierre said ThinPrep provided screeners with a much cleaner and clearer sample, which was easier to read.

Dr Bierre said pathologists had been cautious about supporting the widespread introduction of ThinPrep until the US Federal Drug Administration approved it as a replacement for the pap smear in May 1996.

"But the philosophy behind ThinPrep is that sensitive is the way to go."

ThinPrep would become the standard of care in the next 5 to 7 years, he said.

But Southern Community Laboratories cytopathologist Dr Peter Fitzgerald, who worked as a consultant on the review, said there was no strong scientific evidence to show ThinPrep offered any advantage over conventional cytology.

He said research showed ThinPrep mighty increase the rate of detection of low-grade abnormalities, but these regressed in about 60 per cent of cases and progressed to invasive cancer in about only 1 per cent.

There was also concern that ThinPrep's extra sensitivity could result in falsely identifying disease.

This could mean women were given unnecessary treatment.

"It is important that people get the message that they are not being shortchanged in any way if they have the conventional pap test," said Dr Fitzgerald.

In terms of laboratories using ThinPrep as a money-making venture, Dr Bierre said the test cost more than it made.

He said the $15 to $20 charged for ThinPrep covered the cost of the filter for the machine used to process the sample.

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