The American College of Obstetricians and Gynecologists now says that cervical cancer screenings, taken during a woman's annual Pap smear, can be delayed until the age of 21. The organization formerly recommended that young women begin getting tested within three years of having sexual intercourse for the first time, or no later than their 21st birthday.
The group also said that the screening may not be necessary and could also be harmful to women. Dr. Cheryl B. Iglesia, chair of the panel that set these new guidelines, explained that cervical procedures can potentially lead to complications with pregnancy later in life, including higher risk of Cesarean sections and premature births.
Iglesia noted that the precancerous-appearing abnormalities that young women are likely to develop in the cervix will often dissipate on their own. It is when doctors remove them that injury to the cervix can occur. Further, cervical cancer develops slowly, making the need to discover and treat it less urgent than other cancers.
The new guidelines call for cervical cancer screenings beginning at 21 and recurring every three years for women who are over 30, have had three normal results in a row, and do not have a history of abnormalities. Women who have had hysterectomy for noncancerous reasons and have not had severe abnormalities on past Pap tests, no longer need to have the test. "Overtreating" sexually active adolescent girls and conducting what are considered unnecessary tests were main points of the changes, according to doctors.
It is recommended that women with HIV, who are at a higher risk for developing cervical cancer, or who have other significant medical complications continue to have more frequent screenings.
Dr. Iglesia stated that there was no political agenda behind these new recommendations and that the close timing to the mammogram revisions is "an unfortunate perfect storm." Other reports say the changes have been in process for years.
However, some politicians are taking full advantage of the controversy and coincidence to heat up the health care reform debate. Others are expressing concern that looser guidelines will encourage vulnerable populations -- like sexually active teenage girls -- to avoid medical attention or standard screening completely.
Although these guidelines changes worry me and make me question why it is OK to decrease the number of precautions we take when it comes to women's cancers, my only hope here is that it will bring us back to some productive conversations about how to protect ourselves against HPV, the virus that causes cervical cancer. I'd like to know how the HPV vaccine will or will not factor into screening frequency and if making it available impacted the panel's thoughts on how soon a young woman should be tested for cervical cancer.
What do you make of the timing, politics, and concerns these changed guidelines are stirring up?
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