Nov 20, 2009 12:36 pm US/Eastern
First Mammograms, Now Pap Smears?
American College Of Obstetricians And Gynecologists Calls For Women To Delay First Pap Test, And Be Screened Less Often
NEW YORK (CBS) ―
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Speculoscopy, light-enhanced Pap smear. (file image)
AP
There are new guidelines for another crucial cancer test for women. This time, the changes involve the screening test for cervical cancer, the Papanicolaou test, also known as a Pap smear. The new revisions come just days after controversial changes to mammogram recommendations, which have led to confusion about women's health care.
It's the reason many women visit their gynecologists once a year, for their annual Pap test. But new guidelines for cervical cancer say women of all ages should undergo pap smears less frequently than they do now and young women are advised not to bother at all until age 21. These latest recommendations come from the
American College of Obstetricians and Gynecologists.
The latest guidelines are as follows:
- Most women in their 20s can have a Pap smear every two years instead of annually.
- Routine paps should start at age 21, previously the recommendation had been within the first three years of sexual intercourse.
- Women 30 and older should wait three years between Paps once they've had three consecutive clear tests.
Cervical cancer is caused by certain strains of the extremely common sexually transmitted virus called HPV, for human papillomavirus. There is a new HPV vaccine that should cut cervical cancer in the future; ACOG's guidelines say for now vaccinated women should follow the same Pap guidelines as the unvaccinated.
"Prior to the 1980s, there wasn't good science to dictate how often women should get Pap tests. Since then, we know more about the disease," said Dr. Alan Waxman.
The doctors making the Pap test recommendations say it's just a coincidence that they're coming out at the same time as the hotly disputed call for fewer mammograms, with one member of the panel calling it "an unfortunate perfect storm."
The doctors say there's no political agenda with the recommendations, and that it's not part of any perceived larger plan to slash cancer screening for women.
These new pap test guidelines, they say, had been in the works "long before the Obama health plan came into existence."
Moreover, ACOG cited studies showing no increased risk of cancer developing in women in their 20s if they extended Pap screening from every year to every two years.
As for adolescents, ACOG said cervical cancer in teens is rare - one or two cases per million 15- to 19-year-olds - while HPV-caused cervical abnormalities usually go away on their own, and unnecessary treatment increases the girls' risk of premature labor years later.
The new pap smear guidelines are sure to raise eyebrows as it comes on the heels of the controversial recommendation of a panel which said that women in their 40s generally don't need routine mammograms, and that mammograms can be done once every other year.
"For years, I and other doctors have been preaching 'get a Pap Smear every year.' Now we're going to be saying, 'well we don't need to do it every year,' and it's going to cause lots of confusion," said Dr. Jacques Moritz, Director of Gynecology at St. Lukes Roosevelt Hospital.
"I'm personally against that because I have many friends (who), because of the test before 21 and around 21, found serious problems," Shelby Campbell.
U.S. Preventive Services Task Force's Suggestions
American Cancer Society: Performing Breast Self-Exam
National Cancer Institute Explains A Mammography
Federal Government Web Site On Women's Health
American Congress Of Obstetricians And Gynecologists Response To New Mammogram Guidelines
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