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Group recommends less-frequent Pap tests

The cervical cancer screening advice follows another panel's controversial mammogram report, but experts say it's a much different situation. Still, Paps are the only reason some women see a doctor.

November 20, 2009|By Shari Roan

The college did not alter two key recommendations: Women 65 and older can stop having screening depending on individual risk factors and history of previous abnormal Pap tests. And women at higher risk for cervical cancer -- those who have had previous positive tests for cancerous or precancerous changes, are HIV-positive, have immune-system disorders or were exposed to the drug diethylstilbestrol (DES) in utero -- should continue with frequent screening.

The government-sponsored Preventive Services Task Force and the American Cancer Society will release updated cervical cancer guidelines next year that are expected to closely follow the College of Obstetricians and Gynecologists' new policy.

"The guidelines are more similar than different," said the cancer society's Smith. Less screening, he said, "is the direction we're all moving in."

The biggest effect of the new recommendations will be to reduce millions of unnecessary tests and follow-up procedures in teenage and young-adult women, Waxman said.

Human papillomavirus, or HPV, which causes cervical cancer and infects half of all young women within a few years of sexual activity's start, also causes cell changes called dysplasia. Those abnormal cells are typically removed before they become cancerous. But such treatment may not be necessary.

"When teens get these changes, it behaves differently," Waxman said. "They are more likely to get better by themselves and less likely to get cancer."

For adult women, annual screening was originally based on the concept that the longer women wait between Pap tests, the more likely they are to have a significant abnormality, Waxman said. But recent research has found that it makes no difference in detecting cellular abnormalities if women return for another test one, two or three years after a normal test.

About 3 million to 4 million abnormal Pap results are found each year, according to the National Cancer Institute, but only about 13,000 cases of cervical cancer are diagnosed. About 4,000 women die each year of the disease.


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