Guidelines released in December 2009 from The American Cancer Society and The American College of Obstetricians and Gynecologists indicate that not all women need an annual Pap test, which screens for cervical cancer. For most women, the guidelines now advise Pap testing at regular intervals – up to 3 years, for some – instead of every year, based on their age, risk factors, and previous cervical cancer screening test results.
While some women who dread this particular exam may cheer, others wonder “Why?” What has changed in our collective medical knowledge that may extend this exam’s frequency from annually to every 3 years for some women? And some are asking, “Are the new guidelines safe for us?”
Dr. Susan Haas, Medical Specialty Director of Obstetrics and Gynecology at Harvard Vanguard Medical Associates, explains why the guidelines changed in the following short video:
Getting regular, but less frequent, Pap tests is a safe option for many women. To summarize the new guidelines, The American College of Obstetricians and Gynecologists now recommends that:
- Pap testing start at age 21
- Women ages 21-29 be screened every two years
- Women age 30 and older can be screened every three years if they have a history of normal Pap tests.
- It is reasonable to stop screenings at age 65 or 70 among women who have three or more negative results in a row and no abnormal test results in the past 10 years.
- Women with certain risk factors and health issues, regardless of age, may need more frequent screening. These risk factors include women who have HIV, are immunosuppressed, were exposed to diethylstilbestrol (DES) in utero, or have been treated for cervical intraepithelial neoplasia (CIN) or cervical cancer. If you have one or more of these risk factors, speak with your doctor about what is the right frequency of Pap testing for you.
The bottom line is that research has shown less frequent cervical screening to be just as effective in preventing cancer as annual screening. Moreover, as Dr. Haas described, over-screening can potentially register an abnormal result that will naturally resolve itself through the body’s own immune system, but may lead to unnecessary treatment as a result.
Cervical cancer rates have fallen more than 50% in the past 30 years in the US due to the widespread use of the Pap test. The incidence of cervical cancer fell from 14.8 per 100,000 women in 1975 to 6.5 per 100,000 women in 2006. The American Cancer Society estimates that there will be 11,270 new cases of cervical cancer and 4,070 deaths from it in the US in 2009.
Click here to get the facts on cervical and other women’s cancers, including information about who is most at risk, how cancer can be prevented, available screenings and their recommended frequency, warning signs and symptoms, and how cervical cancer is treated.
As Dr. Haas recommends, talk to your doctor about the frequency of screening that’s appropriate and comfortable for you. And remember – in addition to Pap tests, all women should have a periodic health review which should include:
- A general examination (height, weight, body mass index, blood pressure)
- A breast exam
- A pelvic exam
- A discussion of health and lifestyle, including personal and family health history; medications and supplements used; current diet, exercise and sexual practices; and use of tobacco, alcohol and other drugs.
- And possibly tests for cholesterol, blood sugar, sexually transmitted diseases, and a waist-circumference measurement
