Updated 11/20/2009 11:36 PM
Medical Group Recommends Less Frequent Pap Smears
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The American College of Obstetricians and Gynecologist recommended a change Friday in how often women get tested for cervical cancer.
It came days after a suggested switch in mammogram routines -- and is sparking some similar debate.
The group says most women in their 20s can have a pap smear every two years, instead of annually. The panel says biannual tests would be enough to catch slow-growing cervical cancer.
The guidelines also say routine paps can start at age 21, even if someone has been sexually active earlier.
For years, the recommendation has been that women get their first cervical cancer test within three years of their first sexual intercourse.
Women 30 years and older should wait three years between exams, once three tests in their 20s have come back clear.
More screening is suggested for women with previous cervical conditions.
The update was published in Friday's Obstetrics & Gynecology journal and is meant to decrease unnecessary testing and potentially harmful treatment.
The American Cancer Society says the recommendations are very similar to what the group suggests.
"Beginning screening for cervical cancer at age 21 is quite effective in terms of identifying cancer and even identifying pre-cancerous lesions that can be removed before they turn into cancer," said David Momrow of the ACS.
The ACS points out that cervical cancer is extremely rare in adolescents, with just one or two cases per million each year, and that false positives from pap smears could lead to unnecessary, even harmful, treatment.
But some medical professionals have mixed feelings.
"My initial reaction is this didn't seem right, didn't sit well," said Dr. George Mussalli, chair of the Department of Obstetrics and Gynecology at St. Vincent's Comprehensive Cancer Center. "The pap smear test, for better or for worse, drives the motivation to keep the annual appointment, and a lot more goes on at those annual visits than just a pap smear."
The doctor says key discussions on safe sex, nutrition, and other women's health issues often take place during those visits.
Most women who spoke with NY1 Friday said they favored the old guidelines.
"I would rather do it every year, just to be on the safe side," said one New Yorker.
"I think it should not change. It should remain how it is," said another. "I guess it has to do with being a woman and I've known people who have had to deal with that and it's something every woman should be concerned with and we should fight to keep it the way it is."
"I think it's important to get tested and be cautious because my old gynecologist told me she's diagnosed people who have never been sexually active, who are 18, and from that evidence I think it's good to be cautious," said a third.
"If you have been a healthy woman for a long time, I think two years is fine, because doctors are expensive, procedures are expensive," offered a fourth. "But if you have a history in your family of cancer, you should go once a year."
Medical professionals say women with HIV and other immune-weakening conditions, and those who've received adverse results from previous pap smears should not change their screening procedure until they speak with their doctors.
The announcement came just days after a federal task force set off debate by issuing guidelines that say women should not begin routine screenings until the age of 50.
The obstetricians' group says the timing of the announcements is a coincidence.