Pap Smear Guidelines
American College of Obstetricians and Gynecologists changes position on annual tests for women in their 20s.
November 20, 2009
The change by the American College of Obstetricians and Gynecologists comes amid a completely separate debate over when regular mammograms to detect breast cancer should begin. The timing of the Pap guidelines is coincidence, said ACOG, which began reviewing its recommendations in late 2007 and published the update Friday in the journal Obstetrics & Gynecology.
- Most women in their 20s can have a Pap smear every two years instead of annually, say new guidelines that conclude that's enough to catch slow-growing cervical cancer.
The guidelines also say:
- Routine Paps should start at age 21. Previously, ACOG had urged a first Pap either within three years of first sexual intercourse or at age 21.
- Women 30 and older should wait three years between Paps once they've had three consecutive clear tests. Other national guidelines have long recommended the three-year interval; ACOG had previously backed a two- to three-year wait.
Paps can spot precancerous changes in the cervix in time to prevent invasive cancer, and widespread use has halved cervical cancer rates in the U.S. in recent decades. About 11,270 new cases will be diagnosed this year, and about 4,070 women will die from it, according to American Cancer Society estimates.
- Women with previous cervical abnormalities or immune-weakening conditions (such as HIV) may need more frequent screening.
Cervical cancer is caused by certain strains of the extremely common sexually transmitted virus called HPV, for human papillomavirus. There is a new HPV vaccine that should cut cervical cancer in the future; ACOG's guidelines say for now that vaccinated women should follow the same Pap guidelines as the unvaccinated.
But the updated guidelines reflect better understanding of HPV. Women's bodies very often fight off an HPV infection on their own without lasting harm.