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New Cervical Cancer Guidelines: Less Screening

Women 30-65 Can Go 5 Years Between Screenings if They Have Normal Pap and HPV Tests

No Pap Tests Before Age 21 continued...

The guidelines do not apply to women with a history of cervical cancer or prenatal exposure to the drug diethylstilbestrol (DES) or to women whose immune systems aren’t functioning normally, such as those with HIV. Such women may need more intensive screening.

As a result of cervical cancer screening, death rates from cervical cancer in developed countries have plummeted. This year, the American Cancer Society estimates that more than 12,000 women will be diagnosed with the disease and more than 4,200 will die. A majority of cases occur in women who hadn’t been screened in more than five years, if ever.

Skip the Annual Checkup?

Pap tests are the reason many women go in for annual checkups, and the task force cautions women not to skip seeing a doctor regularly. However, Moyer says, that doesn’t necessarily mean yearly appointments. “The value of the annual visit with your physician is going to be determined by the individual patient and the physician,” she says.

Just because they don’t need a Pap test doesn’t mean women should go years without seeing a doctor, says Howard W. Jones III, MD, director of gynecological cancer at the Vanderbilt-Ingram Cancer Center, who wasn’t involved in writing the new guidelines. After all, Jones says, high cholesterol, high blood pressure, and diabetes can go undetected for years in people who aren’t screened for them.

Whether women still need routine pelvic exams is another question, says Maryam Guiahi, MD, an assistant professor of obstetrics and gynecology at the University of Colorado School of Medicine.

In an article published last year, Guiahi and her co-authors concluded that new technology, such as urine tests and do-it-yourself vaginal swabs for screening for sexually transmitted infections, and new guidelines, such as longer intervals between Pap smears, make routine pelvic exams obsolete.

But Guiahi says she still gets patients who expect a Pap test at every visit. She tells them that frequent screening isn’t recommended. It’s not a tough sell. “Once you explain it ... many women are amenable to not taking their pants off.” 

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