Guidelines push back age for Pap exam
NEW YORK - New guidelines for cervical cancer screening say women should delay their first Pap test until age 21 and be screened less often than recommended in the past.
The advice, from the American College of Obstetricians and Gynecologists, is meant to decrease unnecessary testing and potentially harmful treatment, particularly in teenagers and young women. The group’s previous guidelines had recommended yearly testing for young women, starting within three years of their first sexual intercourse, but no later than age 21.
The reason for the change in recommendations is that young women are especially prone to develop abnormalities in the cervix that appear to be precancerous but that will go away if left alone. But when Pap tests find the growths, doctors often remove them, with procedures that can injure the cervix and lead to problems later when a woman becomes pregnant, including premature birth and an increased risk of a Caesarean.
Cervical cancer is caused by a sexually transmitted virus, human papillomavirus. Only some people who are exposed develop cancer; in most, the immune system fights off the virus. If cancer does develop, it can take 10 to 20 years after exposure.
The new guidelines also say that women 30 and older who have three consecutive Pap tests that were normal, and who have no history of seriously abnormal findings on the test, can stretch the interval between screenings to three years. Women who have a total hysterectomy for a noncancerous condition, and who had no severe abnormalities on previous Pap tests, can quit having the tests entirely.
