Women can safely skip the unpleasant speculum-based exam for human papillomavirus screening and instead test for the virus themselves using a vaginal swab, two new studies confirm.

Genital HPV infections are thought to be responsible for more than 99% of cervical cancers. At least partly because the speculum exam can be uncomfortable or even painful, “half of the women in the U.S. who have cervical cancer did not undergo a screening test in the past ten years," Dr. Diane Harper of the University of Michigan, who led both studies, said in a statement

"We should try to make (the test) a more comfortable experience,” she added.

Countries that have adopted self-screening for HPV, including Sweden, Australia and the Netherlands, have also reduced their incidence of cervical cancer, Harper noted.

The researchers recruited 193 women, ages 25 to 65, and instructed them to use vaginal swabs, which were then sent to the laboratory. The volunteers also underwent speculum exams.

Testing of all the samples for 15 high-risk HPV types showed that “using swabs is equivalent to speculum-based collection,” Harper said.

The swab test results, as reported in Preventive Medicine Reports, were in agreement with global data on HPV prevalence, reinforcing the usefulness of vaginal swabs, the researchers said.

A separate study published in JAMA Network Open, involving 56 women with physical disabilities, found the vaginal swabs to be equally effective and much less painful and traumatic than speculum-based screening.

“The swabs cannot replace having a conversation with your doctor. However, it can save the vast majority of women from getting unnecessary speculum tests,” Harper said.

PAXLOVID BENEFIT IN VACCINATED SENIORS PROVES MINIMAL

Pfizer’s anti-viral Paxlovid provided little protective benefit against severe COVID-19 in a study of the treatment in older Canadians who had been vaccinated against the virus, researchers reported on Thursday in JAMA.

For eight months in 2022, the province of Ontario, Canada restricted the use of Paxlovid to symptomatic, COVID-19-positive adults aged 70 years and older, unless patients were immunocompromised or had other risk factors.

During that period, among 1.6 million vaccinated Ontario residents ages 65 to 74, the policy to restrict Paxlovid to those aged 70 and older resulted in a more than doubling of Paxlovid prescriptions, but no improvement in COVID-related hospitalization, all-cause hospitalization, or all-cause mortality in that age group, according to the report.

“Our study effectively rules out the notion that Paxlovid causes large reductions in COVID-19 hospitalization in vaccinated older adults,” study leader Dr. John Mafi of the David Geffen School of Medicine at UCLA said in a statement.

A course of the two-drug treatment costs well over a $1,000, he noted.

“While we cannot rule out a small reduction in COVID-19 hospitalization, our results indicate that at best, Paxlovid’s potential effect on COVID-19 hospitalization among vaccinated older adults is four times weaker than the effect originally reported in Pfizer’s 2022 clinical trial.”