In The News

Dr. Caren Schaecher, St. Luke's Hospital

New cervical cancer screening guidelines mean fewer Pap tests

Recently, the American College of Obstetricians and Gynecologists once again updated its recommendations for cervical cancer screening, a screening commonly done with a Pap smear. The most significant changes are in how often a woman should be screened and the type of screening recommended. The newest guidelines include:

• A woman should be screened beginning at age 21, regardless of when she first has sexual intercourse.
• Between the ages of 21 and 29, a woman should be screened with a Pap test every three years rather than yearly or every two years as previously recommended.
• Women 30 to 65 years old can be screened in one of two ways: with a Pap test alone every three years; or with a Pap test and HPV (human papilloma virus) test every five years.
• Women over age 65 who have had regular screening with normal results can discontinue screening.
• Women who have had a total hysterectomy (removal of the uterus and cervix) with no history of cervical cancer or pre-cancer no longer need to be screened.

A major reason for these changes is to ensure the benefits of testing while minimizing the risks. Cervical cancer is caused by infection with HPV, which is transmitted during sexual intercourse. HPV infections are most common in a woman's teenage years and early 20s. However, most strains of HPV are harmless and transient, and often any pre-cancerous lesions clear up on their own. For women age 30 and older, the chance of an HPV infection progressing to cervical cancer is extremely low, and risk factors decrease with age. Also, cervical cancer develops slowly.

Follow-up for abnormal screening results often involves removing part of the cervix, which can affect a woman's fertility. Too frequent screening can lead to unnecessary procedures.

Each woman should discuss the new guidelines with her healthcare provider. It's also important to note that although a woman may need fewer Pap tests, she still needs an annual wellness visit to evaluate overall health and medications, discuss age-appropriate health screenings and have a thorough examination.

Dr. Caren Schaecher is a board-certified OB/GYN at St. Luke's Hospital. Call 314-576-0930.

This article was published in the St. Louis Post-Dispatch on April 18, 2013.