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Some Women May Not Need Annual Pap Smears

Posted Dec 09 2009 12:00am
by Holly Hosler

In case you missed it in the big news about the recent USPSTF mammography recommendations, the American College of Obstetricians and Gynecologists (ACOG) has also revised guidelines, specific to when women should get Pap smears.

The ACOG now recommends that women have their first Pap smear (test for the early detection of cervical cancer) at age 21 (rather than 18), regardless of their sexual histories. Also, most women no longer need Pap smears on an annual basis, and most can stop having them after age 65 or 70 if they have had no abnormal results in the past 10 years.

According to the ACOG, Pap smears conducted prior to age 21 have resulted in too many false positives, with women undergoing unnecessary procedures to eliminate abnormal growths in cervical tissue. The ACOG argues that by treating these cervical abnormalities, young women are put at risk for too much treatment, anxiety and infertility. Cancer of the cervix in women under age 21 is rare; odds of contracting it stand at about 1 in a million.

The new guidelines also say that women aged 21 to 29 should have a Pap smear once every two years, and women in their 30s and older should have one every 3 years provided that their last three tests were negative.

“ACOG has developed its guidelines based upon significant evidence based clinical data,” says David L. Zisow, M.D., F.A.C.O.G., gynecologist and associate chief of minimally invasive surgery at Northwest Hospital.

However, before you think you can skip your annual Pap smear this year, talk with your doctor about what is the best course of action for you. Regular Pap smears save lives, and the new guidelines should not be taken as a pass to start being lax about your gynecological health.

“Guidelines are just that - a starting point from which to think about what may be best for the individual patient and should never be substituted for clinical judgment,” explains Dr. Zisow. “Doctors will still need to exercise good clinical judgment in selecting appropriate patients to screen - or not to screen - in light of each individual’s history and medical circumstances.”
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