New Guidelines Discourage Annual Pap Tests

"I think everyone is on the same page for the first time that I can remember," Saslow said.

By having both a Pap smear and an HPV test — known as co-testing — women ages 30 to 65 can safely go five years between screenings if the results are negative, said Dr. Michael LeFevre, co-vice chair of the U.S. Preventive Services Task Force, which published the other set of guidelines in the Annals of Internal Medicine.

This is the first time that co-testing has been formally recommended as an alternative to Pap smears alone, although some doctors have been offering the tests in tandem for some time.

Studies show that the death rate for cervical cancer is not affected by lengthening screening intervals, LeFevre said, and the move would reduce the number of false-positive tests and unnecessary follow-up procedures.

"You can have fewer Pap smears and it is still as safe and effective," he said. "That is the product of science and what we've learned about HPV."

Both the U.S. Preventive Services Task Force and the consortium of medical groups led by the American Cancer Society continue to emphasize that Pap tests are important, however. More than 11,000 new cases of cervical cancer are diagnosed each year in the U.S. and about 4,000 women die from the disease, largely because they didn't get screened and their cancers were caught too late.

"If you look at cervical cancer today in the U.S., at least half of the women who get it have not been screened," LeFevre said. "Extending out the interval to three years or five years doesn't mean, 'Gee, this must not be important.' "

The new guidelines are the latest in a number of reports issued in recent years by the task force and other medical groups recommending fewer routine cancer screenings because of emerging science showing that test intervals can be safely lengthened and because doing so would reduce the distress caused by false-positives and harm resulting from unnecessary procedures.

In a controversial 2009 decision, for example, the U.S. Preventive Services Task Force recommended scaling back mammogram screening for some women. And in 2010, the American Cancer Society retreated further from recommending routine prostate cancer screening by saying that men over age 50 should discuss the risks and benefits with their doctors before having a prostate-specific antigen test.

In lieu of the combined Pap smear-HPV test combination, the task force screening guidelines also offer women ages 30 to 65 the option of having a Pap smear alone every three years.

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