The American College of Obstetricians and Gynecologists says young women (under 21) who are not sexually active do not need to be screened for cervical cancer. The new recommendations say women under age 30 should get Pap smears every two years, rather than annually, and those over age 30 should get Pap smears every three years, rather than every two to three years.
The timing is curious given the firestorm that erupted over the recommendation that
women should wait to get mammograms.
The Los Angeles Times reports that
some will surely see all this as a sign of health care rationing:
"The two sets of revisions might give rise to a suspicion that women's health has suddenly taken a back seat to economic pressures, cancer specialists acknowledged Thursday. The annual Pap smear is the only reason some women see a physician, and some doctors fear that, without a sense of urgency to get that test, many women might skip preventive healthcare.
" 'I understand some people may have a cynical view of this,' said Robert A. Smith, the American Cancer Society's director of cancer screening. 'But we want to assure women this is not motivated to save money.'
"Both sets of revisions emphasize the risks associated with annually screening millions of people who will never get breast or cervical cancer. But the creators of the cervical screening recommendations say the two sets of guidelines are markedly different.
"For starters, the cervical screening recommendations reflect a broad consensus among medical groups. Most organizations agree that Pap testing does not lose its value if women are screened less frequently, said Dr. Edward Partridge, chairman of the cervical cancer screening guidelines panel for the National Comprehensive Cancer Network.
" 'Annual screening is too much,' he said. 'There is no real controversy there.' "
"Further, the updated guidelines are based less on the potential for inaccurate results -- the concern regarding mammograms for women under 50 -- than on evolving knowledge about how cervical cancer develops. The disease progresses slowly, and many precancerous changes resolve on their own."
The New York Times says the panel
making the Pap smear recommendations did not intend to be associated with the to the mammography debate:
"Arriving on the heels of hotly disputed guidelines calling for less use of mammography, the new recommendations might seem like part of a larger plan to slash cancer screening for women. But the timing was coincidental, said Dr. Cheryl B. Iglesia, the chairwoman of a panel in the obstetricians' group that developed the Pap smear guidelines. The group updates its advice regularly based on new medical information, and Dr. Iglesia said the latest recommendations had been in the works for several years, 'long before the Obama health plan came into existence.'
"She called the timing crazy, uncanny and 'an unfortunate perfect storm,' adding, 'There's no political agenda with regard to these recommendations.'
"Dr. Iglesia said the argument for changing Pap screening was more compelling than that for cutting back on mammography -- which the obstetricians' group has staunchly opposed -- because there is more potential for harm from the overuse of Pap tests. 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. But when Pap tests find the growths, doctors often remove them, with procedures that can injure the cervix and lead to problems later when a woman becomes pregnant, including premature birth and an increased risk of needing a Caesarean."
