Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments

Pap Smears for Women: New Guidelines

Right in the middle of the national firestorm about Mammogram recommendations, the American College of Gynecologists (ACOG) has issued new guidelines for screening of cervical cancer. After 40 years of successfully convincing women to get pap smears annually, the new recommendations say women should not get their first pap test until age 21 and the intervals for testing can then be stretched out.

The new recommendations say that women should start pap screening at age 21 (not teens who are sexually active as previously recommended) and then every two years through age 29. Women age 30 and over with three negative pap smears can stretch it out for three years. Women over age 65 can stop getting pap tests if their previous tests have been negative. Women who have had a hysterectomy for non-cancer reasons never need a pap smear.

The study experts looked at pooled data from around the world. We now know that cervical cancer is caused by certain strains of Human Papillomavirus (HPV), however most women infected with HPV will not develop cervical abnormalities. Most women who contract HPV have an effective immune system that clears the virus. Paps that are done too frequently can show abnormalities that would, in the majority of cases, clear spontaneously.

The researchers also found that pap tests are difficult to interpret and there is inconsistency among cytologists reading the slide. Upon a second review, most results that were reported as showing abnormalities were downgraded to normal.

The study points out that abnormal pap tests lead to a sequence of further testing, biopsies and excisional procedures that can adversely affect a young woman’s reproductive health.

In summary, the new guidelines recommend:

  • Start pap smears at age 21 regardless of prior sexual activity (no need at all in virgins).
  • Test every 2 years to age 30
  • After age 30, test every 3 years if prior tests are normal
  • Stop at age 65 if prior tests have been negative.
  • No paps needed for women who have had hysterectomy if there was no cancer

It is ironic that we now have two significant changes for screening tests in women’s health. According to the chair woman of the ACOG study group, Dr. Cheryl Iglesia, it was a bizarre coincidence that their guidelines hit right at the same time as the mammogram controversy.

The 12 page recommendations from ACOG can be found here.

*This blog post was originally published at EverythingHealth*

You may also like these posts

    None Found

Read comments »

Comments are closed.

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »

Commented - Most Popular Articles