Results of a five-year study involving 45,000 women provided the strongest evidence yet in favor of using human papillomavirus (HPV) testing, Chris Meijer and colleagues from the VU University Medical Centre in Amsterdam reported in The Lancet Oncology.

Most cases of infection with the sexually transmitted virus are cleared naturally by the immune system, but persistent infection with certain HPV strains can lead to cervical cancer.

In recent years, tests for these "high-risk" strains have been developed by companies including Roche and Qiagen.

The new tests are known to work well in detecting HPV, but the Dutch study is the first to show they are better than Pap smears alone over two screening rounds set five years apart.

The researchers, who looked at women aged 29 to 56, said use of HPV tests led to earlier detection of pre-cancerous lesions, allowing for treatment that improved protection against cancer.

Hormuzd Katki and Nicolas Wentzensen from the U.S. National Cancer Institute said the results reinforced earlier findings, and provided "overwhelming evidence" of the benefits of including HPV testing in cervical screening programs.

(Reporting by Ben Hirschler; Editing by David Hulmes)

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