The report cautions that if doctors disregard the guidelines, it will be difficult to control the cost of screening the more than 100 million women in the U.S. for cervical cancer.
And now, as policy-makers try to cut health-care costs, doctors worry that discouraging women from making regular gynecological appointments could mean fewer opportunities to screen them for other deadly diseases such as breast and ovarian cancer.
Waiting three years between Pap tests is too long, say some local health-care providers who have urged patients to be screened every year.
"So many things can change in three years," said Shari Layton, a nurse at a private practice in downtown Orlando who has performed Pap smears for nearly 30 years. Women can meet new sexual partners and contract genital human papillomavirus, or HPV, the sexually transmitted disease that can cause cervical cancer, she said. "I don't think there's any risk in testing every year."
Some doctors say that many women consider their OB-gyn their primary-care physician, and may not have medical care other than their annual Pap test.
"If they don't bring a woman in on an annual basis, they think they will lose the women for other reasons," said Dr. Mona Saraiya, the study's lead author. "The Pap test was sort of the hook."
When a federal task force last year urged doctors to stop ordering mammograms for women under 50 who were at low risk for breast cancer, doctors were deeply divided about whether to adopt the new guidelines. But the three groups that issue cervical-cancer guidelines — the American Cancer Society, the U.S. Preventative Services Task Force and the American College of Obstetrics and Gynecology — all agree that women don't need testing every year. Doctors just don't appear to be following the guidelines.
"Physicians have been slow to adopt the new guidelines," said Dr. Veronica Schimp, a gynecologic oncologist at Orlando Health. One reason, Schimp said, is that doctors may not understand how slowly HPV causes cancer in the cervix, sometimes taking several decades after infection.
Physicians who have always advised their patients to get an annual Pap smear are reluctant to suggest that patients be less vigilant about the screening, even though more-frequent testing hasn't been shown to reduce cervical-cancer deaths.
By some estimates, 20 million Americans are infected with HPV. Last year in the U.S., 11,000 women were diagnosed with and 4,000 women died from cervical cancer. Doctors test for cervical cancer by performing a Pap smear in which they scrape cells from the cervix and look for any abnormalities. Another type of screening, called an HPV test, is performed in the same way but looks for the virus that can cause cervical cancer.
Source : http://articles.orlandosentinel.com/2010-06-15/features/os-cervical-guidelines-20100614_1_cervical-cancer-cervical-cancer-pap-test464