New guidelines indicate that women who have had normal HPV and pap test results in the 30-65 year old age bracket will only need to be tested every five years. This revision was put into place after physicians found that “combining a Pap test with a human papillomavirus (HPV) test can safely extend the interval between cervical cancer screenings from three years to five years” in this age group.
Cervical screenings can be very uncomfortable and even painful so this may come as a pleasant surprise for women with no abnormal test histories in the past ten years.
Women who opt for the Pap test alone, are advised to get screened every three years.
It is also believed that if women undergo unnecessary screenings they could be putting themselves at greater risks; the authors of the guidelines explain: “The harms of more frequent screening — such as a greater chance of abnormal test results can lead to further, sometimes invasive testing — outweigh the benefits of early detection of slow-growing precancerous changes in the cervix. Often, those precancerous changes resolve without any treatment. Persistent infection with certain types of HPV can lead to cervical cancer.”
Older guidelines suggested that women be screened within three years of becoming sexually active. While the average age that women experience their sexual debut is 17 race, socio-economic status, and geographic location skew the averages. The median ages by race are as follows: White (16.6), Black (15.8), Hispanic (17), Asian American (18), and other (17.4). This means that in the past, the majority of American women should have been screened between the ages of 15-20.
In its new update, though, the task force says it found little evidence that sexual history should affect the age at which women begin to get screened. And, the guidelines note, there is no evidence that screening women younger than 21 reduces diagnoses of or deaths from cervical cancer.
Other Changes with the New Guidelines
HPV testing is not recommended for women in their 20s because people in that age group can have HPV infections that resolve without treatment.
Women over age 65 can stop getting screened if they’ve had at least three consecutive negative Pap tests or at least two negative HPV tests within the previous 10 years. The guidelines do not apply to women with a history of cervical cancer or prenatal exposure to the drug diethylstilbestrol (DES) or to women whose immune systems aren’t functioning normally, such as those with HIV. Such women may need more intensive screening.
Cervical Cancer Deaths Plummet
As a result of cervical cancer screening, death rates from cervical cancer in developed countries have decreased significantly. This year, the American Cancer Society estimates that more than 12,000 women will be diagnosed with the disease and more than 4,200 will die. A majority of cases occur in women who hadn’t been screened in more than five years, if ever.
Some people are skeptical of the new guidelines and decided to tweet:
And doctors like Howard W. Jones III, MD, director of gynecological cancer at the Vanderbilt-Ingram Cancer Center, agree: “Just because they don’t need a Pap test doesn’t mean women should go years without seeing a doctor. After all, Jones says, high cholesterol, high blood pressure, and diabetes can go undetected for years in people who aren’t screened for them.”
Could this just be one more way for insurance companies to increase their profit margins?