Smear test study draws worrying conclusions

More than half of women with abnormal smear tests displayed strains of the potentially cancerous human papilloma virus, preliminary results from an ongoing study show.

Twenty-eight of the 49 women tested positive for the virus, known to cause cervical cancer and genital warts.

According to the head of Mater Dei Hospital's Obstetrics and Gynaecology Department, Mark Brincat, 19 of the women had high risk HPV and another five had multiple strains of the virus.

A fifth of the women tested - nine - were found to have type 16 of HPV, one of the worst causative agents of cervical cancer. Types 16 and 18 of the virus are believed to cause 70 per cent of cervical cancers. None of the patients was found to be infected with HPV 18. More than 130 types of HPV have been identified, with as many as 40 of them normally transmitted through sexual contact.

Prof. Brincat said almost all the women, bar one, were under 30 years old. The only older woman was negative for HPV, he said.

The study, unveiled by Prof. Brincat during a talk for doctors organised by A M Mangion, which imports one of the two vaccines against strains of HPV, was carried out as part of doctors' postgraduate education. They intend to test 100 women with abnormal smear tests and a future study will try to determine the prevalence of HPV among the general population through tests at health centres.

According to statistics from the Malta Cancer Registry, 101 women were diagnosed with cervical cancer between 1996 and 2006, with 66 succumbing to the disease between 1997 and 2007.

When contacted, Genitourinary Clinic head Philip Carabot said there was need for a national cervical screening programme, adding that he was not surprised with the results since HPV was the main cause of abnormal smear tests.

A study carried out a few years ago by surgical pathologist Albert Cilia Vincenti, Malta National Cancer Registry head Miriam Dalmas, and Roderick Busuttil from St Luke's Hospital Cytology Laboratory, found that nearly half of the women diagnosed with cervical cancer between 1992 and 2002 had never undergone a smear test, which could have detected the problem early and led to effective treatment.