Claire Williams thought her pap test would be business as usual.
The 29-year-old had been having the tests for years. She'd just been married and the newlyweds were settling into their first home together. Then came her cytology results.
The test found high-grade abnormal cells.
"I blew it off, thinking there was nothing to worry about," Ms Williams said.
But a biopsy confirmed she had cervical cancer.
"It came out of nowhere," Ms Williams said. "We thought our whole lives lay in front of us ... then it was this black hole of unknown."
Two weeks later she was relieved to discover the cancer was operable, but Ms Williams knows many women aren't so lucky.
"Early detection is what saves lives. Anything we can do to pick these cancers up early is going to save lives," she said.
A new clinical trial has confirmed screening for the human papillomavirus (HPV) is more effective than pap smears at detecting precancerous lesions, offering women a more accurate early warning system to protect them against cervical cancer.
High-grade cervical abnormalities (known as CIN2+) were detected in 1 per cent of women who were HPV screened, compared to 0.1 per cent of women given pap tests, found the phase 1 Compass trial involving over 5000 women aged 25-64.
The difference in detection rates may change after the researchers conduct a Phase 2 trial involved 121,000 women, but it was clear HPV screening trumped cytology pap tests, said the study's lead author Professor Karen Canfell, director of Research at Cancer Council NSW.
"We found the HPV test was substantially more effective at picking up high-grade abnormalities compared to pap tests," she said.
From December, the renewed national cervical cancer screening program will see two-yearly pap tests for women aged between 18 and 69 will be replaced by a five-yearly HPV test for 25 to 74-year-olds.
The program is predicted to cut the cervical cancer incidence and mortality by at least 20 per cent.
HPV testing was able to offer women significantly earlier intervention because it detected the presence of HPV virus DNA itself, while pap tests identified changes once they had already begun manifesting in cells.
Women who test negative for HPV run a very low risk of developing cervical cancer for a long time - often over ten years - justifying the longer interval in HPV screening.
Building on previous international evidence, the results suggest the new screening program will offer older unvaccinated women protection as well as offering vaccinated women "double-barrelled protection," Professor Canfell said.
"It's an incredible public health story. By building on the success of vaccination, the move to this new testing technology means Australia will have the best protection against cervical cancer developing of any country in the world," she said.
The procedure for collecting a sample for HPV testing is the same as the procedure for having a Pap smear. A doctor or nurse will take a small sample of cells from a woman's cervix and send it to a pathology laboratory for testing.
The study by researchers at Cancer Council NSW and Victorian Cytology Service is the first trial of its kind conducted among a population with a high rate of HPV vaccination, with Australia being the first country to introduce a national publicly-funded vaccine program for cervical cancer.
HPV screening allows doctors to stratify a woman's cervical cancer risk and set her on the right management pathway, whether it be HPV screening in five years' time for women who return a negative result, cytology testing, physical investigation or immediate treatment depending on the initial test results, Professor Canfell said.
Whether HPV screening could lead to over-treatment was an important consideration before the approval of the new screening program, but coupled with the high uptake of the HPV vaccine, the new program should see fewer women referred for further testing, she said.
An estimated 912 women will be diagnosed with cervical cancer in 2017. More than one in four cervical cancer patients will die within five years of their diagnosis, according to national statistics.
"Anything that can reduce the number of women who die of cervical cancer or who need [invasive] treatment would be amazing," said Ms Williams, now 35 years old and a mother to an eight-year-old boy and four-year-old girl, both of whom will be vaccinated.
"If we can pick up on the signs early, it could save my daughter's life - and the lives of many other daughters," she said.
The story HPV test trumps pap smear for cervical cancer detection, trial shows first appeared on The Sydney Morning Herald.