HPV DNA Test Detects More Infections Than Pap Smear, Study Shows | Brazil Health Update

A new molecular test for high-risk human papillomavirus (HPV) has identified infections at nearly six times the rate of conventional Pap smears in women from satellite cities around Brasília, Brazil. The findings, presented Friday at the EUROGIN 2026 international HPV congress in Vienna, Austria, are part of the TENDA+ project, a Brazilian initiative aimed at improving cancer of the cervix screening access.

The study, conducted by a multidisciplinary team from institutions including the Butantan Institute and Campo Real University, analyzed 753 cervical samples collected from mobile units deployed in underserved areas of the Federal District. Participants had an average age of 48, ranging from 20 to 69 years old.

The core finding centers on the comparative performance of the two screening methods. Genotyping for HPV DNA detected positivity in 16.6% of samples, while the Pap smear identified cellular changes in only 2.92% of cases. This difference is significant given that, according to Brazil’s Ministry of Health, nearly 100% of cervical cancer cases are caused by HPV, and early detection of infection greatly improves prevention outcomes. In 2025, 7,249 women in Brazil died from complications related to cervical cancer.

Among the 125 women with confirmed HPV infection through DNA testing, the 40-to-60 age group accounted for 54.4% of cases. The most prevalent genotypes were HPV-16 (17.6%), HPV-68 (16.01%), HPV-66 (12.80%), HPV-58 (11.20%), and HPV-39 and HPV-52 (9.6% each). The high incidence in the 40-60 age range is notable as this demographic is not currently targeted by Brazil’s HPV vaccination program.

Brazil’s Ministry of Health is transitioning to DNA-HPV testing as the primary screening method for cervical cancer within the Unified Health System (SUS). Currently, the test is available in Pernambuco, Pará, Bahia, Minas Gerais, São Paulo, Paraná, and Rio de Janeiro, with a goal of nationwide implementation by December 2026.

However, the two methods are not intended to replace each other entirely. “Pap cytology and genotyping are complementary and will be better indicated according to the subtype of virus with which the woman has been infected,” explained Maria dos Anjos, a gynecologist with the Delboni and Lavoisier laboratories.

The new Ministry of Health protocol stipulates that women testing positive for HPV-16 or HPV-18, which are responsible for the majority of cervical cancer cases, will be directly referred for colposcopy – a procedure allowing visualization of the cervix. Women with other high-risk HPV genotypes will first undergo Pap cytology. This strategy aims to both broaden virus detection and expedite diagnosis for those at highest risk, while avoiding unnecessary testing for others.

Vaccination remains the primary preventative measure against HPV. The SUS currently offers vaccination to individuals aged 9 to 14. In June of this year, the Ministry of Health expanded eligibility to those up to 19 years old, to accommodate those who missed vaccination during the recommended age range. The vaccine is also available in the private sector, costing around R$ 3,000 for the complete schedule, and is recommended up to age 45.

“When we expand access to prevention and early diagnosis, we offer women the opportunity to avoid a cancer that is often preventable,” stated gynecologist Maria dos Anjos.