New guidelines released just one month ago from The American College of Obstetricians and Gynecologists (ACOG) – and supported by The American Cancer Society – indicate that most women only need a Pap test, which screens for cervical cancer, every 3 to 5 years, rather than annually.
Dr. Sarah Zarek, an OB/GYN at Harvard Vanguard’s Copley practice in Boston, and Dr. Ted Yurkosky, an OB/GYN at Harvard Vanguard in Chelmsford, explain why the guidelines have changed in the following short video:
To summarize the new guidelines, ACOG now recommends that:
- Pap testing start at age 21
- Women ages 21-29 be screened every three (3) years
- Women age 30 and older can be screened every three years, but if HPV (human papilloma virus) testing on the same Pap test specimen shows she is not a carrier of a high-risk HPV, the next Pap test can be done in five (5) years
- After age 65 or 70, most women no longer need a Pap test
- Women with certain risk factors and health issues, regardless of age, may need more frequent screening. These risk factors include women who have HIV/AIDS, are immunosuppressed, were exposed to diethylstilbestrol (DES) in utero, or have been treated for cervical intraepithelial neoplasia (CIN) or cervical cancer. If you have one or more of these risk factors, speak with your doctor about what is the right frequency of Pap testing for you.
The reason for these new guidelines is two decades of research with conclusive proof that certain high-risk strains of HPV cause cervical cancer. We now know how it is transmitted, how few infected women develop cancer, and how slowly cancer develops. Additionally, the technique for collecting and analyzing cervical cells for the Pap test has improved. As a result of this new knowledge and new technology, we are confident that getting regular, but less frequent, Pap tests is a safe option for women.
Cervical cancer rates have fallen more than 50% in the past 30 years in the US due to the widespread use of the Pap test. The incidence of cervical cancer fell from 14.8 per 100,000 women in 1975 to 6.6 per 100,000 women in 2008. Mortality from the disease has undergone a similar decrease from 5.55 per 100,000 women in 1975 to 2.38 per 100,000 women in 2008. The American Cancer Society estimates that there will be 12,170 new cases of cervical cancer and 4,220 deaths from it in the US in 2012.
Click here to get the facts on cervical cancer, including information about who is most at risk, how it can be prevented, available screenings and their recommended frequency, warning signs and symptoms, and how cervical cancer is treated.
At Harvard Vanguard, we encourage you to speak with your primary care clinician or OB/GYN about the frequency of screening that’s appropriate and comfortable for you. And remember – in addition to Pap tests, all women should have a periodic health review which should include:
- A general examination (height, weight, body mass index, blood pressure)
- A breast exam
- A pelvic exam
- A discussion of health and lifestyle, including personal and family health history; medications and supplements used; current diet, exercise and sexual practices; use of tobacco, alcohol and other drugs; as well as stresses in your life that might be affecting your health
- Tests for cholesterol, blood sugar, sexually transmitted diseases, and a waist-circumference measurement every few years