A major new study says some women who had negative results from previous cervical cancer screening can wait for as long as five years before their next Pap test. But women should continue to follow current guidelines said Dr. Matt McDonald, the medical director at Novant Health Gynecologic Oncology Associates.
Current guidelines say all women should begin screening for cervical cancer at age 21, according to the American Cancer Society.
Women between the ages of 21 and 29 should receive a Pap test every three years.
For women between the ages of 30 and 65, the guidelines recommend a combination of tests that include a Pap test and HPV screen every five years. An alternative option for this group of patients is a Pap test every three years.
McDonald said the data are starting to show that HPV testing alone is as effective as Pap test at detecting abnormalities, but it is not recommended yet as a solo test.
Women that are older than 65 who have had regular screenings in the past which did not show any serious pre-cancerous risk do not need additional cervical cancer testing.
“Women older than 65 with no history of abnormal cell growth for the last 20 years and women who have had a hysterectomy and no abnormal test results for the last 20 years do not need further cervical cancer exams,” McDonald said.
Screening for abnormal cell changes in the cervix can prevent most cervical cancers when detected early. Cervical cancer used to be the leading cause of deaths by cancer in the U.S., according to the Centers for Disease Control and Prevention. But in the last 40 years, the incidence of cervical cancer and deaths from the disease have decreased significantly. Many attribute this decline to regular testing for cervical cancer with the Pap test exam.
The study looked at data for nearly 1 million women who had received cervical cancer screenings between 2003 and 2014. The researchers found that the odds of cervical cancer dropped with each five-year combination of tests results demonstrating no HPV and no abnormal cell from the Pap test.
Women typically got screened every year until the guidelines changed in 2012, but with the revised guidelines for cervical testing providers fear that women could put themselves at higher risk by forgoing their annual exams.
“There is concern in the medical community that women may think they don’t need to have their annual OB-GYN visit. That they only need to see their gynecologist every five years,” McDonald said. “This visit is more than just a screening for cervical cancer. It’s also a pelvic exam, a breast exam and a check of the uterus and ovaries for cancerous masses.”
McDonald says there’s no proof that this notion puts more women at risk for cancer, but there is a fear that “something might be missed.”
Women most at risk for developing cervical cancer are those that are exposed to the HPV virus. “Women who are more sexually active and who have multiple partners are most at risk,” he said.
“Vaccinating for the HPV virus is really the best protection against cervical cancer,” McDonald said. And this applies to both girls and boys.
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