New Cervical Cancer Screening Guidelines
Joan Pellegrini, MD
Tuesday, May 15, 2012
Good news for women: gone are the days of recommending annual Pap exams.
So, why did the guidelines change? It turns out that more frequent screening was turning up more abnormal results thus leading to more testing but no benefit. Most of the time, these abnormal results were nothing to worry about. If we screen every three years we can still catch cervical disease before it becomes cancer and yet not miss more cancers. If HPV testing is added to the Pap, then screening can be extended to every five years.
More good news: we no longer have to subject ourselves to screening before the age of 21. Cervical cancer is caused by the Human Papillomavirus (HPV). There are many types of HPV and most of us are infected at some point in our lives by at least one of the types. Only a few of the HPV types will cause cervical cancer. Most women who become infected with the virus are able to fight it off and never have a problem. However, if a young woman who just contracted the right type of HPV has a Pap test early on in the infection, the Pap will be abnormal. But, chances are she will clear the infection and have a normal Pap in a few years. This is mainly the reason why the new guidelines recommend not screening before the age of 21. This is opposed to the previous guidelines which recommended starting screening no later that age 21.
The U.S. Preventive Services Task Force website has a more detailed description of the new guidelines.
These guidelines are for women at low risk and with no history of an abnormal Pap test. The most important component of screening is that women actually get screened. How long the interval is between screens is less important. As usual, we recommend you discuss your particular situation and concerns with your personal healthcare provider.
I started this segment off with the good news. But, the bad news for women is that although cervical cancer rates are down significantly since we started getting Pap exams, there are still over 12,000 cases of cervical cancer per year in this country. And, the vast majority of cancers occur in women who have never been screened. This gives us some room for improvement. So, we can now reduce the frequency of screening but we still need to get every woman to get screened.