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Low-risk women should not be over-screened for cervical cancer.

Most obstetrician/gynecologists over-screen low-risk women for cervical cancer, according to a recent study. The findings, published in February 2005 in the American Journal Obstetrics and Gynecology, revealed that the majority of physicians overuse the Pap test, which identifies cervical cancer and precancerous cells.

Physicians routinely screen 18-year-old patients even if they are not sexually active, and continue to administer unnecessary annual Pap tests to 35-year-old women who have had three or more normal test results and are, therefore, deemed to be at low-risk for cervical cancer. These practices conflict with guidelines put forth by the American Cancer Society (ACS) and the American College of Obstetricians and Gynecologists (ACOG) that call for less frequent screening of low-risk women.

The National Women's Health Network believes that physicians should not over-screen women who have a low risk of cervical cancer. Unnecessary screening consumes resources that can be better used for other purposes--such as screening women with high risk of cervical cancer, as well as screening low-income or uninsured women who may not be able to afford regular OB/Gyn visits. False positives (test results that erroneously indicate cancer) are another problem that arise from too-frequent screening and often lead to invasive, traumatic, and sometimes harmful follow-up procedures.

The ACS issued updated cervical cancer screening guidelines in 2002. These recommendations stipulate that screening should begin approximately three years after a woman becomes sexually active, and that all women, even those who are not sexually active, should have an initial screening by age 21. ACS recommends that women under 30 receive a standard Pap test annually, or a liquid-based Pap test every two years. Women over 30 who have had three consecutive normal Pap results should be screened no more than once every two to three years, while those over 70 who have also had repeated normal results can discontinue cervical cancer screenings completely, Women whose cervixes were removed during hysterectomy need not be screened at all (unless the hysterectomy was part of treatment for cervical cancer or pre-cancer).

Despite the scientific evidence and medical guidelines against over-screening, the majority of physicians administer yearly Pap tests to healthy women in their 30s, and most begin screening patients unnecessarily at age 18. Cervical cancer screening is both important and effective, but the focus should be on extending the benefits of screening to those women most in need of services. For a copy of the Network's fact sheet on cervical cancer and Pap tests, please call NWHN or visit:

Electra Kaczorowski is the NWHN Internship/ clearinghouse Coordinator Coordinator
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Copyright 2006 Gale, Cengage Learning. All rights reserved.

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Title Annotation:You Heard It Here First
Author:Kaczorowski, Electra
Publication:Women's Health Activist
Geographic Code:1USA
Date:Jan 1, 2006
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