From Our 2012 Archives
Less Frequent Pap Tests Safe for Most Women, Ob/Gyn Group Says
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MONDAY, Oct. 22 (HealthDay News) -- Most women need testing for cervical cancer only every three to five years, rather than annually, according to the American College of Obstetricians and Gynecologists.
For women aged 30 and older, the Pap test, as it is called, should be done along with a test for human papillomavirus (HPV) every five years, according to new guidelines released by the organization Monday.
"The yearly Pap test was an arbitrary decision when it was recommended years ago," said Dr. David Chelmow, chairman of obstetrics and gynecology at Virginia Commonwealth University Medical Center in Richmond.
This change should reassure women, because it is scientifically based on the results of several studies, said Chelmow, who led the development of the guidelines.
The college recommended women aged 30 to 65 get an HPV test along with the Pap test because "we know HPV is the cause of most cervical cancer," Chelmow said.
If both tests are normal, no further tests are needed for five years. If the HPV test is positive, more frequent testing is needed. And if both the HPV and Pap test are positive, further testing and treatment will be done, he said.
The guidelines, published online Oct. 22 and in the November print issue of the journal Obstetrics & Gynecology, are in line with recommendations released in March by the American Cancer Society, the American Society for Colposcopy and Cervical Pathology and other medical groups.
Routine Pap testing has cut the rate of cervical cancer by more than 50 percent in the United States. "Women who develop cervical cancer are mostly those who have never been screened," Chelmow said.
According to the American Cancer Society, more than 12,000 women will be diagnosed with cervical cancer in 2012, and more than 4,000 will die from it.
For the Pap test, cells scraped from the cervix are examined under a microscope for signs of cancer or precancerous abnormalities.
Cervical cancer is caused by some types of HPV, a common sexually transmitted infection. Most women with healthy immune systems can eliminate HPV infections, but a small number with persistent HPV infection will develop cervical abnormalities that lead to cancer, Chelmow explained.
According to the new guidelines:
The new guidelines were designed to strike a balance between protecting women from cervical cancer while avoiding unnecessary tests that could lead to complications, Chelmow said.
Dr. Elizabeth Poynor, a gynecologic oncologist and pelvic surgeon at Lenox Hill Hospital in New York City, said women shouldn't interpret the recommendation for less frequent Pap tests to mean they don't need an annual "well woman" visit.
"We really need to highlight to the women we treat that just because werecommend a Pap test every three to five years doesn't mean you only seeyour doctor every three to five years," she said.
The annual exam addresses other health and wellness concerns, she noted.
Also, women should review these recommended changes with their doctorto see how they apply to them, she said. "Women really need to discuss with theirdoctor how these guidelines apply specifically to them and their healthhistory," she said.
Copyright © 2012 HealthDay. All rights reserved.
SOURCES: David Chelmow, M.D., Leo J. Dunn Distinguished Professor and chairman, department of obstetrics and gynecology, Virginia Commonwealth University Medical Center, Richmond; Elizabeth Poynor, M.D., Ph.D., gynecologic oncologist and pelvic surgeon, Lenox Hill Hospital, New York City; November 2012 Obstetrics & Gynecology
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