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Cancer Health Center

Many Women May Not Need Yearly Pap Smear

Screening Every Three Years is OK for Many, Experts Say
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Oct. 15, 2003 -- Most women over 30 who have had at least three consecutive negative Pap smears can safely forego annual cervical cancer screening, new government-supported research suggests.

The findings support revised Pap smear guidelines published last year by the American Cancer Society and two months ago by the American College of Obstetrics and Gynecology. Both groups now say the interval between Pap smears can be as long as three years for many women.

No Cancers Identified

The Pap smear is the most widely utilized cancer detection tool in the U.S. But only about one-third of eligible women are regularly checked for cervical cancer.

It has been long suggested that many women over 30 with a history of normal Pap smears do not need annual screenings. But many physicians have been reluctant to abandon the practice, in part because they see it as a way to get women in the door for yearly checkups.

Some have also expressed concern that the evidence in favor of doing Pap smears less frequently is inconclusive. The new study, published in the Oct. 16 issue of TheNew England Journalof Medicine, should allay those fears, says researcher George Sawaya, MD, of the University of California, San Francisco.

The study included nearly 32,000 women between the ages of 30 and 64 with a recent history of at least three consecutive normal Pap smears. During a three-year follow-up in which the women continued to receive annual screenings, no cervical cancers were identified and only 15 precancerous lesions were found.

Using an established prediction model, the researchers concluded that between one and three additional cancers would be identified per 100,000 women by screening annually versus every three years. They calculated that roughly 200,000 additional Pap smears and 11,500 more invasive smears for questionable findings would have to be done to identify one extra cervical cancer in women aged 45 and over.

The CDC and the National Cancer Institute helped fund the study.

American Cancer Society Guidelines

The American Cancer Society has called for an end to universal annual Pap smears for more than a decade, says ACS director of breast and gynecologic cancer Debbie Saslow, PhD. The group's Pap smear guidelines call for:

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