Wednesday, February 21, 2018

New guidelines discourage annual Pap tests

LOS ANGELES — For generations of women, it's been an ingrained medical ritual: Get a Pap test every year. Now two influential groups of medical experts say that having cervical cancer screening once a year is not necessary and, in fact, should be discouraged.

Many women can wait as long as five years between screenings, the new guidelines say.

The call for screening cutbacks, released Wednesday, is based on evolving knowledge accrued in the past decade about human papillomavirus, a common sexually transmitted disease that causes most cervical cancer, and the availability of an HPV test that shows whether a woman has been infected with the most common variants of the virus.

In recent years, advice on cervical cancer screening has varied widely among medical organizations, with experts recommending screening intervals ranging from one to three years and varying according to a woman's age and whether she is sexually active.

The fact that the two new documents are largely in agreement should reassure women and their doctors that experts have neared a consensus, said Debbie Saslow, director of breast and gynecological cancer for the American Cancer Society, which led a consortium that was one of the groups issuing the guidelines.

By having both a Pap smear and an HPV test — known as co-testing — women ages 30 to 65 can safely go five years between screenings if the results are negative, said Dr. Michael LeFevre, co-vice chairman of the U.S. Preventive Services Task Force, which published the other set of guidelines in the Annals of Internal Medicine.

Studies show the death rate for cervical cancer is not affected by lengthening screening intervals, LeFevre said, and the move would reduce the number of false-positive tests and unnecessary followup procedures.

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