WEDNESDAY, March 14 (HealthDay News) -- The annual Pap smear may
soon be a thing of the past, since new guidelines issued Wednesday
say that most women need the cervical-cancer screening only once
every three years.
In its first update since 2003, the U.S. Preventive Services
Task Force (USPSTF) said a yearly Pap smear isn't necessary for
women aged 21 to 65, and that women younger than 21 don't need the
test at all because evidence indicates screening doesn't lower
cervical-cancer rates or deaths in this youngest group.
Screening every three years after age 21 saves the same number
of lives as annual screening, with half the number of biopsies and
fewer false-positive results, according to the USPSTF, an
independent panel of health experts that issues guidelines based on
periodic reviews of scientific evidence. The guidelines were
published online in the
Annals of Internal Medicine.
"We've moved into an age of less is more, so this is just fine-tuning," said Dr. Diana Contreras, division director of obstetrics and gynecology at Long Island Jewish Medical Center in New Hyde Park, N.Y. "Before we used to have a very large hammer, and now our hammer is getting more precise." Contreras was not part of the panel.
More than 12,000 women are diagnosed with cervical cancer each
year and 4,000 die from it, according to the U.S. National Cancer
Institute. Pap smears detect abnormalities in cells scraped from
the opening of the cervix.
The new guidelines, which are broken down by age group and
health history, also say:
"The most important point we want to make is that the highest-risk women are those who have never been screened or haven't been screened in over five years," said Dr. Wanda Nicholson, one of the lead authors of the guidelines and associate professor of gynecology and obstetrics at the University of North Carolina School of Medicine in Chapel Hill.
Contreras agreed. "This is a cancer we could get rid of in this
country if we were able to screen everyone who needs it," she said,
adding that women should continue annual visits to their
gynecologists to monitor other aspects of their reproductive
But this latest iteration of USPSTF screening guidelines
probably isn't the last word on the subject, the experts said. The
long-term effects of widespread Gardasil vaccinations to prevent
HPV infection among adolescents and young adults have yet to be
seen, Contreras and Nicholson said. The U.S. Food and Drug
Administration approved Gardasil in 2006.
"Since I was a [medical] resident, guidelines have changed multiple times," Contreras said. "We also understand how much more common HPV is. The idea is to do the appropriate procedures on the appropriate patients."
Three other national health groups -- the American Cancer
Society, American Society for Colposcopy and Cervical Pathology,
and the American Society for Clinical Pathology -- simultaneously
issued joint cervical-cancer-prevention guidelines that were in
line with those released by the USPSTF.
The U.S. National Institutes of Health has more about
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