A new map for the Pap

It s been in the works for some time now, but on Wednesday, three U.S. cancer groups proposed new cervical cancer screening guidelines. The American Cancer Society, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology jointly proposed guidelines that largely accord with two recent evidence reviews by the U.S. Preventive Services Task Force. Most notably, all four groups recommended that Pap tests for most women be administered only once every three years instead of the more common practice of an annual screening.

More specifically, the guidelines recommend that women begin Pap tests at age 21 and discontinue at age 65, provided they have a normal screening history. The guidelines also call for a stronger emphasis on combined human papillomavirus (HPV) and Pap testing in women over 30 although the Task Force has reaffirmed the Pap test as the best way to identify cervical cancer in women aged 21 to 65. The federal group points to the significant drop in the number of cervical cancer deaths since the Pap test was put to widespread use in the late 1940s.

ACSH's Dr. Gilbert Ross agrees with the new guidelines, observing that pre-cancerous lesions of the cervix grow slowly enough that a Pap test every three years will be adequate to catch it. The more screening you do, he says, the more false positives and subsequent unintended consequences you get. Dr. Ross, a former clinician, also agrees with Dr. Mark Wakabayashi, chief of gynecologic oncology at a California cancer center, who pointed out that the women who don t get Pap tests are the ones who are dying from cervical cancer. In other words: Any one of these tests is better than not having any, says Dr. Ross.