Goodbye pap smear, hello urine test? Cervical cancer screenings could be in for some change.

It may be a little too soon to officially say goodbye to the pap smear (or good riddance), but we may be getting closer to a time when it is no longer the frequent and unpleasant experience that it is for some woman.

Years ago, the cervical exam, which included an uncomfortable (and in some cases painful) process of extracting samples from the uterus to test for signs of cervical cancer, required an annual slog to the doctor's office.

Over the last few years a slew of groups, including the United States Preventive Services Task Force (USPSTF), the American Cancer Society, the American College of Physicians and the American College of Obstetricians and Gynecologists, have recommended against making the pap smear a regular part of annual visits for most healthy, low-risk women who are not pregnant.

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Now a new study by British and Spanish researchers is taking a look at the evidence in favor of replacing a lot of pap tests with a simple, non-invasive urine test. The urine test would screen for human papillomavirus (HPV), which causes cervical cancer in some cases.

The researchers analyzed 14 high quality studies that looked at the effectiveness of urine tests compared to the traditional pap smear for detecting the presence of all HPV, as well as high-risk strains of HPV. And they found that under certain conditions, the urine test was accurate, though not as accurate as the pap smear, for HPV detection.

Compared to the pap smear, the urine test produced a positive HPV test result 87 percent of the time, and a negative HPV test result 94 percent of the time. When it comes to the high-risk strands of HPV, the urine test was less accurate compared to the pap smear.

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The results also indicated that the tests were more accurate when the sample was taken form the first void urine (usually at the beginning of the day) rather than mid-stream or random urine samples.

So is it time to fast-track the urine test?

Potentially. The pap smear has been on the medical scene for more than 75 years. In that time it has become standard practice for gynecologists, producing impressive results in  reducing rates of cervical cancer in the United States, according to Kevin Ault, a gynecologist at the University of Kansas Hospital.

"The pap smear is frequently called the most successful screening test ever," Ault said in an interview. "We've reduced cancer rates 70 to 80 percent in the U.S. It's got a great track record."

Still, about 12,000 people are diagnosed with cervical cancer every year. And false positives, plus the discomfort of the procedure, can turn women away from the doctors's office when doctors want more women to get screened before they develop cancer.

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Ault noted that when a urine test for chlamydia was introduced, for example, it eliminated the need for uncomfortable, invasive examinations with teens, and freed them to talk about other issues like contraception and safe sex. With the approval of a more accurate urine test for HPV (which is still some time away), a similar trend might occur.

"I think what I usually tell my patients is that now you get a chance to talk about a lot of other things that may have been shortchanged, like planing a pregnancy or using another form of birth control," said Ault.

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