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Guideline on cervical cancer has new tack
Source: Agencies |
November 21, 2009, Saturday
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Print Edition
Print Edition
WOMEN in the United States should start cervical cancer screening at age 21 and most do not need an annual Pap smear, according to new guidelines issued yesterday that aim to reduce the risk of unnecessary treatment.
The guidelines from the American College of Obstetricians and Gynecologists now say women younger than 30 should undergo cervical cancer screening once every two years instead of an annual exam. And those age 30 and older can be screened once every three years.
The recommendations are based on scientific evidence that suggests more frequent testing leads to over-treatment, which can harm a young woman's chances of carrying a child full term.
"Over-treatment of minor abnormal pap tests in young women and adolescents can lead to consequences such as pre-term labor in some cases. It increases the risk," said Dr Thomas Herzog of Columbia University in New York, chairman of an ACOG committee on gynecologic cancers.
More agreement
"Pre-term delivery has become a huge problem in the US that has potential serious consequences for the unborn fetus," said Dr Jennifer Milosavijevic, a specialist in obstetrics and gynecology at Henry Ford Health System in Detroit, who supports the guideline changes.
"These new guidelines will allow us to avoid doing unnecessary procedures on the sexually active adolescent female," she said in an e-mail.
The guidelines are unlikely to be met with the kind of rebellion that accompanied new breast cancer screening guidelines during the week, which were largely based on computer projections, Dr Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, said in a telephone interview.
"There is a lot more agreement about the science of cervical cancer screening," Lichtenfeld said.
Prior recommendations called for annual cervical cancer screening to start three years after a woman first becomes sexually active, or by age 21.
Although the rate of human papillomavirus (HPV), a common sexually transmitted disease, is high in this population, rates of cervical cancer are very low.
"We were over-diagnosing and over-treating adolescents and very young women," Herzog said.
The guidelines from the American College of Obstetricians and Gynecologists now say women younger than 30 should undergo cervical cancer screening once every two years instead of an annual exam. And those age 30 and older can be screened once every three years.
The recommendations are based on scientific evidence that suggests more frequent testing leads to over-treatment, which can harm a young woman's chances of carrying a child full term.
"Over-treatment of minor abnormal pap tests in young women and adolescents can lead to consequences such as pre-term labor in some cases. It increases the risk," said Dr Thomas Herzog of Columbia University in New York, chairman of an ACOG committee on gynecologic cancers.
More agreement
"Pre-term delivery has become a huge problem in the US that has potential serious consequences for the unborn fetus," said Dr Jennifer Milosavijevic, a specialist in obstetrics and gynecology at Henry Ford Health System in Detroit, who supports the guideline changes.
"These new guidelines will allow us to avoid doing unnecessary procedures on the sexually active adolescent female," she said in an e-mail.
The guidelines are unlikely to be met with the kind of rebellion that accompanied new breast cancer screening guidelines during the week, which were largely based on computer projections, Dr Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, said in a telephone interview.
"There is a lot more agreement about the science of cervical cancer screening," Lichtenfeld said.
Prior recommendations called for annual cervical cancer screening to start three years after a woman first becomes sexually active, or by age 21.
Although the rate of human papillomavirus (HPV), a common sexually transmitted disease, is high in this population, rates of cervical cancer are very low.
"We were over-diagnosing and over-treating adolescents and very young women," Herzog said.
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