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New Guidelines for Pap and HPV Testing

By EmpowHER June 20, 2012 - 11:27am

If you are a healthy woman age 30 or older, getting a yearly Pap test is so last year.

New guidelines released by the U.S. Preventive Services Task Force (USPSTF), a federal government agency, say Pap testing every three years is now recommended. If you’re 30 or over, add a test for the Human Papillomavirus (HPV), the virus that causes most cervical cancer, and you might not need another test for five years.

The American Cancer Society, in conjunction with other medical specialty societies, also published updated cervical cancer screening guidelines that are very similar to those released by USPSTF.

Current recommendations state that cancer screening of all women should begin at age 21. Experts now agree that girls and women below age 21 should not receive cervical cancer screening. For women aged 21-29, a Pap test every 3 years is recommended for women with normal screening history.

In women younger than 30, the HPV test isn’t performed, unless the Pap test signals a possible problem. That’s because most young women contract the virus and their bodies have not had adequate time to clear the infection on their own
The recommendations state that women 30 and older should receive Pap + HPV co-testing every 5 years as the preferred method of cervical cancer screening. This is because, when paired together, Pap + HPV testing is the most sensitive way to detect women at risk for developing cervical disease. Receiving a Pap test every three years is also considered an acceptable screening schedule.

The new recommendations also say cervical screening should end at age 65, at least for those with an appropriate screening history.

These new recommendations reflect a greater scientific understanding regarding the progression of cervical disease.

According to the experts, cervical cancer typically grows so slowly that regular Pap smears — which examine cells scraped from the cervix — identify cell changes early enough to treat before a tumor even forms. HPV testing goes even further by detecting the presence of the virus that causes most cervical changes, enabling doctors to monitor women who may be at risk for developing cervical changes – before they ever have the chance to develop. This means earlier detection and less unnecessary or life-changing procedures. It should be noted, however, that most women who test positive for HPV will not be diagnosed with cervical disease or cancer. In most cases, the immune system will clear the infection on its own.

Today, about half of all cervical cancer is diagnosed in women who’ve never been screened, or have gone many years between checks.

Keep in mind, that these new guidelines were developed to address cervical cancer screening in the general population. Your doctor will choose the screening method that’s right for you according to your individual health history.

The small changes to the screening guidelines are by no means meant to discourage women from getting screened as recommended, as it clearly saves lives.

Since the United States began screening women in the mid-20th century, cervical cancer, the once most frequent cause of cancer death in women, now ranks 14th for cancer death.

Cervical cancer screening is just one of many important wellness checks that your health care provider performs during your annual healthy woman exam. So, regardless of how often you receive a Pap or HPV test, it’s important that you continue with these yearly visits.

The U.S. Preventive Services Task Force website has a more detailed description of the new guidelines at: http://www.uspreventiveservicestaskforce.org/uspstf11/cervcancer/cervcan...

Sources:

American Journal of Clinical Pathology. “American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology Screening Guidelines for the Prevention and Early Detection of Cervical Cancer” D. Saslow et al. 012;137: pp516-542. DOI: 10.1309/AJCPTGD94EVRSJCG

New Cervical Cancer Screening Guidelines. Media Release, American Congress of Obstetricians and Gynecologists. 14 March, 2012. Accessed online 6 June 2012 at: http://www.acog.org/About_ACOG/Announcements/New_Cervical_Cancer_Screeni...

Screening for Cervical Cancer: U.S. Preventative Services Task Force Recommendations Statement. March 2012. Accessed online 6 June 2012 at: http://www.uspreventiveservicestaskforce.org/uspstf/uspscerv.htm

New Screening Guidelines for Cervical Cancer. American Cancer Society. Stacy Simon. 14 March 2012. Access online at: http://www.cancer.org/Cancer/news/new-screening-guidelines-for-cervical-...

Reviewed June 6, 2012
by Michele Blacksberg RN

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