For the second time in a week, new guidelines call for less-frequent cancer screening for women.
Today, the American College of Obstetricians and Gynecologists will announce changes to its screening guidelines for cervical cancer.
According to The New York Times, the group will advise women to get their first Pap tests at age 21. Previous advice called for a Pap test three years after a woman first had sexual intercourse, but not later than age 21. The group also will recommend that women get the test every two years instead of annually until age 30.
On Monday, the United States Preventive Services Task Force released guidelines that caused a furor. The task force recommended that most women delay the start of routine mammograms until age 50, rather than 40, and that the test take place every other year, not annually. It also recommended against training women to perform breast self-examinations, the Times said.
The timing of the two announcements was “an unfortunate perfect storm,” Dr. Cheryl B. Iglesia, chairwoman of the panel that developed the Pap smear guidelines, told the Times. “There’s no political agenda with regard to these recommendations.”
“Still,” noted the Times, “the new recommendations for Pap tests are likely to feed a political debate in Washington over health care overhaul proposals. The mammogram advice led some Republicans to predict that such recommendations would lead to rationing.”
Iglesia, whose group opposes cutting back on mammography, said there is a more compelling reason to change Pap screening, according to the Times. “The reason is that young women are especially prone to develop abnormalities in the cervix that appear to be precancerous, but that will go away if left alone,” the Times said. Because of Pap tests, doctors often remove the growths, using procedures that can lead to problems later when a woman becomes pregnant.
The National Cervical Cancer Coalition, a patient advocacy group, endorsed the recommendations, The Washington Post reported.
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In my twenties, precancerous cells were found on my cervix and an outpatient procedure occurred. It is likely that the precancerous cells were caused by HPV a sexually transmitted disease, with no warning signs until cancer cells appear.
I can’t believe that during the years when females are most likely to be sexually active outside of a monogamous relationship, that they are now being encouraged NOT to get a yearly pelvic exam/pap smear. These are the years that it’s most critical for women to be mindful of reproductive health. It makes me profoundly sad.
Comment by bmc — November 20, 2009 @ 11:23 am
Big difference between these two recommendations. The mammography recommendation was NOT DONE BY CLINICIANS while the PAP smear rec was done by ACOG– the docs who care for cervical cancer. Another thought that clearly impacted this decision is that the HPV vaccine will continue to have increased penetration in younger women who are not sexually active (or maybe are) and they will be at a significantly lower risk of cervical cancer anyway. Clearly , clinical decisions should be made by clinicians using the best data provided by research but not made by statisticians looking at that same data– they have no accountability vis a vis the patient.
Comment by David Albert, MD — November 20, 2009 @ 5:07 pm
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