The American College of Obstetricians and Gynecologists recently recommended that young women delay getting their first PAP test until the age of 21, citing unnecessary testing and potentially harmful treatment.  Previous guidelines recommended that young women begin screening for cervical cancer within 3 years of sexual intercourse but no later than age 21. In addition, the ACOG also recommended less screening for older women.

There are several reasons why this makes sense:

1. The virus that leads to cervical cancer is often spontaneously cleared by the body’s immune system. This means that no treatment is usually needed. Since treatment involves removing the abnormal cervical tissue, this can lead to problems with the cervix when the woman is pregnant causing higher rates of premature births and C-sections.
2. Cervical cancer is a slow growing cancer so checking the cervix for abnormal cells every 2-3 years is generally, fine.

The new guidelines also recommend that PAP tests be stopped between the ages of 65 and 70 providing that the woman has had 3 consecutive negative PAP tests and no history of abnormal tests in the last 10 years. This differs from previous recommendations in that any history of an abnormal PAP was grounds to continue screening, no matter how far in the remote past the event was.

In addition, the new guidelines say that screening can occur every 3 years for women over 30 if they have had no history of seriously abnormal PAPs and have had 3 consecutive negative PAPs. Again, this is because this cancer is so slow growing that it is felt that any abnormalities can be caught before the precancerous growths turn cancerous.

Given that the Advisory Committee on Immunization Practices has recommended that girls at the age of 11 begin the three-part vaccine for human papilloma virus (HPV), the virus responsible for the vast majority of cervical cancer cases, it makes sense that we can delay the onset of testing for cervical cancer.  Because HPV is a sexually transmitted disease, there is a new HPV vaccine that is also recommended for boys which should further reduce the chances of developing cervical cancer.

It is unfortunate however, that these recommendations, which have been in the pipeline for several years, are being used to make political hay by suggesting that the government, in trying to cut health care cost, is doing so on the backs of women. But it really isn’t true. These recommendations make sense.