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By Melissa Tennen, HealthAtoZ writer
Not all women need yearly Pap smears, according to the American Cancer Society (ACS).
Seeking to prevent needless anxiety among women and unnecessary procedures, the ACS, with input from the National Cancer Institute and other leading medical institutions, developed new guidelines for doctors and health care providers.
The norm in the past was for all women older than 18 to get a Pap smear. However, the ACS, basing its guidelines on evidence collected in the past several years, says a blanket guideline for all women isn't necessary.
The American College of Obstetrics and Gynecology (ACOG) recommends that all women should have an annual pelvic exam, but the frequency of Paps can vary.
- If you are under age 30 or have risk factors, you should get an annual Pap.
- If you are older than 30, but have had three negative (no disease) annual Paps in a row, you only need a Pap every two to three years.
- Even if you are postmenopausal, the ACOG recommends you get a Pap periodically.
- Women who have had hysterectomies should ask their doctor if they need a Pap test.
Also, if a woman has human immunodeficiency virus (HIV) or a weakened immune system, a doctor may suggest yearly Pap tests.
Likewise, the United States Preventive Services Task Force (USPSTF) recommends beginning Pap tests at age 21 or within three years of sexual activity, and recommends screening at least every three years. However, USPSTF recommends against routine Pap screening in women over age 65 who are not at risk for cervical cancer and have had normal Pap smears in the past. USPSTF also recommends against routine Pap smear screening in women who have had a total hysterectomy for benign disease.
"The guidelines strike a nice balance between detection sensitivity to protect women and avoiding over-treatment." says Diane Solomon, M.D., senior investigator of the division of cancer prevention at the National Cancer Institute.
Millions of women have abnormal Pap results every year. But fewer than one half of one percent of abnormal Pap smears show cancer. These are causing unnecessary anxiety and fear among some women who don't understand these odds, Solomon says.
Whether or not an individual needs a Pap smear every year The American College of Obstetrics and Gynecology (ACOG) still recommends that all women should have an annual pelvic exam for early detection of other cancers and conditions which occur in that zone of the body.
Cervical cancer mortality has decreased by more than 70 percent in the past 50 years, according to ACS. Cervical cancer was once the number one cancer for women in the United States. It now ranks 13th in cancer deaths for women. In 2005, about 10,370 cases of invasive cervical cancer will be diagnosed and an estimated 3,700 women will die from this disease. However, when this very slow growing disease is caught at an early stage, the five-year survival rate is nearly 100 percent.
Infection of the cervix with human papillomavirus, a sexually transmitted disease, is the most common cause of cervical cancer. And many women have it. However, the vast majority of women with the infection do not develop cancer.
Most cervical precancers grow very slowly. And the majority of (HPV) infections go away on their own without causing cancer. With the new vaccine now available to prevent cervical cancer if girls are vaccinated while young, the incidence of the disease should drop more in the future.
This article was reviewed and updated June 2007.
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