New pap test rules largely disregarded
CHICAGO — An increasing number of younger women in the United States are delaying their first Pap test for cervical cancer until after they reach 21, reflecting new guidelines, health officials said on Thursday.
But 60 percent of women who have had a total hysterectomy and no longer have a cervix are still getting the tests, a sign that old habits may die hard, experts said.
Although an annual Pap test was once the standard of care, most professional groups including the American Cancer Society, the American College of Obstetricians and Gynecologists, and the U.S. Preventive Services Task Force, a government-backed panel, recommend that most women get tested every three to five years, and that younger women delay their first test until 21.
And these same three groups agree that screening is unnecessary for most women who have had a total hysterectomy — the removal of the uterus and cervix — for non-cancerous reasons. Likewise, women older than 65 who have had years of negative tests no longer need to be screened.
The guidelines are meant to curb overscreening, which increases the risk of unnecessary surgery and preterm birth in younger women, and adds unnecessary cost to the care of women older than 65 who have never had a problem Pap and those who have had their cervix removed.
Two teams at the U.S. Centers for Disease Control and Prevention analyzed Pap test data from 2000 to 2010 to see how well doctors were adjusting to the call for less frequent screening.
They found the number of women aged 18 to 21 who had never been screened doubled, rising to 47.5 percent in 2010. The team also found that in 2010, women age 30 and older were less likely to report having a Pap test in the last three years.
And while Pap testing fell among women who had a hysterectomy, dropping to 60 percent in 2010 from 73 percent in 2000, the number reflects significant overtreatment.
Meg Watson, an epidemiologist with CDC's Division of Cancer Prevention and Control, said there are some women who need to continue screening after a hysterectomy, including those whose surgery was done to remove cancers. But that number is small.
“We feel that this would still be a minority of women, and it should not be the 60 percent that we're seeing now,” she said.
CDC researchers said the guideline changes are recent, but the trends reflect a shift toward adhering to them.
Show commenting policy
TribLive commenting policy
You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.
We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.
While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.
We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers.
We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.
We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.
We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.
We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.
- Obama offers Marine leader as Joint Chiefs chair
- Ex-CIA deputy: Benghazi distorted
- Senate leader Reid wants delay on fast-track trade proposal
- New York City officer dies; homicide charge to be filed
- NYPD officer shot over weekend dies
- Researchers find new, elusive bird species
- Former tech executive Carly Fiorina enters presidential race
- McCain renews push to have military, not CIA, manage drone strikes
- Ousted Secret Service agent Smith remains on payroll, House committee learns
- Lynch takes office as U.S. Attorney General
- GOP leaders able to forge deal on budget