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Entries in Pap Smear (3)

Thursday
Mar152012

New Guidelines Discourage Yearly Pap Tests

Keith Brofsky/Thinkstock(WASHINGTON) -- While Pap smears remain an essential part of cervical cancer prevention, new guidelines discourage the once-a-year screenings that have been a part of women’s health for years.

New recommendations from the U.S. Preventive Services Task Force, which is part of the Department of Health and Human Services, state that women who are 21 to 29 years old only need a Pap smear every three years. And those under the age of 21 do not need a Pap smear at all, regardless of sexual history.

And healthy women age between the ages of 30 and 65 need a Pap smear only every five years  if they combine it with a test for human papillomavirus, or HPV,  which can develop into cervical cancer.

The guidelines, published in the Annals of Internal Medicine, are in sync with those of the American Cancer Society and the American Society of Clinical Pathology. Previously, the medical groups recommended Pap smears at least every three years.

But they’ve found that testing every three years prevented just as many cervical cancer deaths as testing every year. But the annual testing brought on false-positives, unnecessary biopsies, which bring a risk of infection, pregnancy complications and infertility, and, of course, unnecessary stress.

“The big point is that every woman needs to get screened,” Dr. Richard Besser, chief health and medical editor at ABC News, said on ABC’s Good Morning America Thursday. “Almost half of women never get tested, and their cancers are picked up when they have symptoms.  But beyond that, read these guidelines, think about it and talk to your doctor about what type of screening and how frequently is right for you.”

The Pap smear was first introduced in 1941, and reduced deaths from cervical cancer, which was once the No. 1 cancer killer among women, by about 70 percent, according to the American Cancer Society.

“Cervical cancer screening is a success story, but the more testing you do, the more you run the risk of false positives, and potential harm of over treatment,” Dr. Wanda Nicholson, a task force member and associate professor of obstetrics and gynecology at University of North Carolina at Chapel Hill School of Medicine, told ABC News last  October.

Nevertheless, women still need their annual pelvic and breast examinations.

“With all these different recommendations, we run the risk of having people to start missing their Paps and make it seem like they’re not important enough,” Dr. Jacques Moritz, director of gynecology at St. Luke’s-Roosevelt in New York City, said in October. “You still need your annual exam. That means, you need your breast and pelvic exam. You just don’t need the actual swabbing of the cervix every year.”

Copyright 2012 ABC News Radio

Friday
Mar022012

Pap Smears Improve Cervical Cancer Survival, Research Confirms

Keith Brofsky/Photodisc/Thinkstock(NEW YORK) -- Regular Pap smears improve the chances of surviving cervical cancer, according to Swedish research, confirming the life-saving benefits of screening every three years during a woman's 20s, 30s and 40s.

The findings about the benefits of widespread testing every three years are particularly relevant for women in this country, where the U.S. Preventive Services Task Force last fall recommended that healthy women 21 to 65 undergo a Pap smear every three years, rather than continuing to make the test an annual medical ritual.  The task force noted that overtesting has enormous financial and physical consequences for women.

Sweden is a good natural laboratory for studying cervical cancer survival for several reasons.  It has a strong national screening program that calls women in for testing every three years from ages 21 to 50 and every five years from 51 to 60, maintains good databases tracking how they fare, and provides broad access to testing and care.

"This is an excellent study and helpful for the screening message," said Dr. Mark Einstein, director of gynecologic oncology at Montefiore Medical Center in the Bronx, N.Y.  "In such a highly accessible health system as there is in Sweden with registries that are the envy of the world, this study shows that Pap testing impacts survival from cervical cancer.  It also tells us that Pap tests are still an essential part of cervical cancer screening."

Einstein noted that cervical cancer used to be the number one cancer killer of women in the early 20th century, but that after the adoption of widespread measures that today also include testing for human papillomavirus (HPV) -- a sexually transmitted infection responsible for the vast majority of cervical malignancies -- as well as HPV vaccination, "cervical cancer does not even make the top 10 prevalent cancers in U.S. women anymore."

However, he said, "In the United States, more than half of women who get cervical cancer have never been screened or have been under-screened."

Swedish women diagnosed with cancer detected through a Pap screen within the previous six months had a better prognosis than those diagnosed because they came in with symptomatic cancer, researchers from Uppsala University and the Karolinska Institute reported.  In addition, women whose symptomatic cancer was diagnosed during the three or five years between regular tests fared better than symptomatic women who were overdue for repeat screening, they found.

Their results, based on a study of the 1,230 Swedish women diagnosed with cervical cancer between 1999 and 2001, and followed for an average of 8.5 years afterward, appeared online Thursday in the British Medical Journal.

The researchers sought to determine whether detection of cervical cancer by screening resulted in a better prognosis or just resulted in earlier diagnosis, and found that the prognosis indeed was better if the testing caught the cancer.  Looking at the big picture, they found that screened women whose cancer was picked up by a Pap test had a higher so-called cure rate -- meaning they survived cancer-free -- than those whose cancers were found after they already had symptoms.

Copyright 2012 ABC News Radio

Wednesday
Oct192011

Task Force Recommends Women Get Fewer Pap Tests

Peter Dazeley/The Image Bank(WASHINGTON) -- The U.S. Preventive Services Task Force announced Tuesday that healthy women between the ages of 21 to 65 should only receive a Pap smear every three years. The federal panel, which is made up of experts in prevention and primary care, also did not support regular HPV screening for most women.

The experts warned that women are currently receiving too many Pap tests, saying the excessive screenings could cause more harm than good.

Instead of continuing to overtest, the task force said it would be better to reach out to those who have never been screened.

"There are a number of women who have never been screened, and that remains a challenge," said Wanda Nicholson, one of the task force leaders and associate professor of obstetrics and gynecology at University of North Carolina at Chapel Hill Medical Center. "We need to keep those women at the top of our priority list and brainstorm for interventions for better access."

Since the Pap smear became a regular part of women's health, deaths from cervical cancer, which was once the No. 1 cancer killer among women, have dropped dramatically.

"Cervical cancer screening is a success story, but the more testing you do, the more you run the risk of false positives, and potential harm over treatment," said Nicholson . "Cervical biopsies are associated with pain and bleeding, they can cause short-term anxiety and worry about these subsequent procedures, and those treatments can [up the] risk of poor pregnancy outcomes, including preterm or low-birth weight babies."

The new recommendations coincide with most of the task force's 2003 recommendations. One difference: The older guidelines recommended screening begin within three years of becoming sexually active, or at the age of 21, whichever comes first. Now, doctors say there is no need to begin regular screening before the age of 21, whether a woman is sexually active or not.

Most experts agree with the new guidelines.

"Cervical cancer can be slow growing and there really is no need for annual testing," said Dr. Ranit Mishori, assistant professor of family medicine at Georgetown University School of Medicine. "The hard part will be convincing patients, and particularly other doctors, that annual screens are not needed."

The task force also discouraged regular Pap screening among teenagers, which is consistent with the recommendation from the American Academy of Pediatrics. Women older than 65 and those who have had their cervix removed are also discouraged from regular screenings.

"This latest USPSTF recommendation against HPV screening and for less frequent Pap testing further endorses that more is not always better when it comes to evidence-based preventive care," said Dr. Mark Fendrick, a professor in the department of internal medicine at University of Michigan School of Public Health. "Excess testing comes at the expense of patient inconvenience [and] discomfort, unnecessary costs, as well as the mental anguish and potential side effects of false positive results."

The American Cancer Society has the same recommendations for Pap testing, but has a different view for HPV testing.

"The main difference is that, dating back to 2002, the American Cancer Society and several other organizations recommended that HPV testing, along with the Pap test, is a good option for screening women starting at age 30," said Debbie Saslow, the American Cancer Society's director of breast and gynecologic cancer, who noted that several studies show the testing provides even further insight into cancer prevention.

Two years ago, the task force made new recommendations that low-risk women receive a mammogram every two years, rather than every year. Last week, the task force stirred up debate when the panel recommended against PSA tests for prostate screenings in healthy men, which many get yearly.

The task force also recommended against testing women younger than 30 for HPV. The doctors wrote there is insufficient evidence as to whether HPV testing, alone or in combination with Pap smears, adds to cervical cancer prevention. "HPV often clears on its own and is prevalent in younger patients," said Mishori. "Not screening so frequently will give time for the infection to clear on its own, as it often does, and help ensure that too many unnecessary follow-ups and procedures will be avoided."

It is important to note that a Pap smear does not mean annual screening. Experts noted that women often confuse the two, but women still need their annual pelvic and breast examinations.

"With all these different recommendations, we run the risk of having people to start missing their Paps and make it seem like they're not important enough," said Dr. Jacques Moritz, director of gynecology at St. Luke's-Roosevelt in New York City. "You still need your annual exam. That means, you need your breast and pelvic exam, you just don't need the actual swabbing of the cervix every year."

Copyright 2011 ABC News Radio







ABC News Radio