Nov 21, 2009 10:52 am US/Eastern
Not All Docs Agree With Pap Smear Recommendations
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
Two days after a controversial change in mammogram guidelines, there's another suggestion for women to reduce cancer screenings. This time, it's pap smears, which detect cervical cancers.
It's part of a yearly exam with a gynecologist, and it detects infections, abnormal cervical cells, and even cervical dangers. Now new guidelines advise that women can delay having their first pap test and many more can wait longer to go back for follow-up screenings.
Nobody looks forward to one, but yearly pap smears have been credited with dramatically decreasing the cervical cancer rate in the United States. When detected early, the five-year survival rate for cervical cancer is about 91 percent. And if it's detected before it has invaded any of the surrounding tissues, the five-year survival rate is nearly 100 percent.
"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 of the College of Obstetrics and Gynecologists.
Now, the college has come out with new recommendations. Women can delay having their first pap smear, they say, until the age of 21, as opposed to three years after the start of sexual activity as previously recommended. Women in their 20s need to be tested every two years as opposed to every year, and women 30 and older should wait three years to be re-tested once they've had three consecutive clear results.
But not all doctors agree with these new guidelines.
"For years, I and other doctors have been preaching to 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. Jacquez Moritz, Director of Gynecology at St. Luke's Roosevelt Hospital.
The research is based on findings that more frequent testing did not catch significantly more cancers. Moreover, testing often resulted in girls and young women experiencing unnecessary stress, anxiety, even potentially harmful treatments because of suspicious cells that would not cause any problems if just left alone.
Cervical cancer grows very slowly – over 10, even 20 years, so the new research found that if you wait until 21 and get screened every two years after that, it's probably not going to make a difference.
"What women need to understand is that cervix cancer is a disease that develops over years, over the course of 7 to 10, sometimes even longer," said Dr. William Burke of The Valley Hospital, in Ridgewood, New Jersey.
Also, the cervical cancer vaccine should prevent many women from developing cancer in the first place.
There is no indication as to what the insurance companies will do, but historically when we've seen recommendations like this published in the U.S., the insurers have typically moved to be supportive of those guidelines.
Click here for more information on the recommendation by the American Congress of Obstetricians and Gynecologists.
Click here for more information from the Department of Health and Human Services.
(© MMX, CBS Broadcasting Inc. All Rights Reserved.)
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