Federal panel recommends pap smear every three years

A federal panel says healthy women do NOT need to get a pap smear every year after all. While many physicians, including me, strongly support the recommendation, there are some worried that the recommendation will lead to women deciding that getting a Pap smear is not that important.

The Los Angeles Times “Booster Shots” reports that the US Preventive Services Task Force (USPSTF) has made a recommendation “that women over age 21 should undergo Pap smears to test for cervical cancer only once every three years.”

This is “somewhat” in line with “a new set of proposed guidelines” from multiple medical groups, including the American Society for Clinical Pathology.

However, the two sides “diverge … on screening for HPV along with the Pap smear. The medical groups say that for women ages 30 and up, it’s not a bad idea; but the task force says there isn’t enough evidence to suggest that it’s a good enough idea to justify the risks.”

The AP reports, “‘The more tests that you do, the more likely you are to be faced with a false-positive test’ that leads to unnecessary biopsies and possible harm, said Dr. Michael LeFevre, one of the task force leaders and a professor of family and community medicine at the University of Missouri. ‘We see an emerging consensus that annual Pap tests are not required for us to see the benefits that we have seen’ from screening, he said.”

Rather, the task force thinks that “more lives probably could be saved by reaching women who are not being adequately screened now.”

Bloomberg News notes, “About 12,700 new cases of cervical cancer will be diagnosed in the US this year, resulting in 4,290 deaths, according to the National Cancer Institute. Most cases of cervical cancer are caused by” infection with HPV.

HealthDay reports that the recommendations come from “results from two evidence reviews, both published Oct. 18 in the Annals of Internal Medicine.”

The first paper suggested that “HPV testing is more sensitive, but less specific than the Pap test,” meaning “women who have nothing wrong with them will test positive with HPV testing, and this may cause potential harm.”

The second review “looked at the appropriate ages to initiate and discontinue cervical cancer screening” and concluded that screening should “continue to begin at age 21” and can end at 65 if the woman “is not considered high risk for cervical cancer.”

MedPage Today reports, “Similarly, screening is unnecessary in women who have had a hysterectomy for benign disease. They cautioned that ‘clinicians should confirm that a total hysterectomy was performed (through surgical records or inspecting for absence of a cervix); screening may be appropriate when the indications for hysterectomy are uncertain.'”

Medscape reports, “The proposed guidelines from the ACS/ASCPP/ASCP are posted online and are open for comments.”

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