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 Women ages 30 to 65 can choose to receive a Pap test every three
years or a human papillomavirus (HPV) test every five years,
according to the U.S. Preventive Services Task Force (USPSTF). The
group did not previously recommend HPV testing without a Pap test.
"Women and providers should continue to recognize that cervical
cancer is a serious disease that can be prevented," said Dr. Maureen
Phipps, a member of the USPTF.
"Women who can be identified early through screening can have
effective treatment for cervical cancer and go on to lead robust
lives," said Phipps, who is also chair of obstetrics and gynecology
at the Warren Alpert Medical School of Brown University in
Providence, Rhode Island.
Cervical cancer was once a leading cause of cancer death for women
in the U.S., but the death rate has been cut in half thanks mostly
to screening, according to the American Cancer Society (ACS).
Nearly 12,800 women in the U.S. will be diagnosed with cervical
cancer in 2017, according to the ACS. About 4,200 women will die of
the disease.
The USPSTF last addressed cervical cancer screening in 2012, when it
advised women ages 21 to 65 to have a Pap test every three years.
Women ages 30 to 65 could lengthen the time between screenings to
five years if they also received an HPV test at the same time.
A woman's experience does not differ by the screening; both of the
tests require analysis of cells scraped from the cervix. But the Pap
test - also known as cytology - looks for potentially cancerous
cells on the cervix. The HPV - or hrHPV - test looks for the virus
that can cause cervical cancer.
After a review of new evidence, the USPSTF recommends that women
ages 21 to 29 receive a Pap test every three years. For women ages
30 to 65, they recommend either a Pap test every three years or an
HPV test every five years.
Unless a women is at high risk for cervical cancer, the USPSTF
recommends against screening after age 65.
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Phipps told Reuters Health that the HPV test may not be right for
younger women since infections with the virus often clear up on
their own. Additionally, they recommend against screening among most
older women since the risk of cervical cancer is low.
As for now allowing women between 30 and 65 to choose between Pap
and HPV tests, the USPSTF writes that the individual tests "offer a
reasonable balance between benefits and harms."
They caution that HPV testing leads to much higher rates of
additional testing than Pap testing. They did not examine the costs
of these screenings, however.
The American College of Obstetrician and Gynecologists (ACOG) still
recommends Pap testing alone or in conjunction with HPV testing,
said Dr. Linus Chuang, who is professor of obstetrics, gynecology
and reproductive science at the Icahn School of Medicine at Mount
Sinai in New York.
"I don’t think this will make American obstetricians and
gynecologists change practice, because they will look at ACOG as
gold standard," said Chuang, who was not involved with the new
recommendations. "But this will challenge it."
The USPSTF is accepting public comments on its draft recommendations
until October 9, online at http://bit.ly/2jlQBpC.
SOURCE: http://bit.ly/2wZcSOC USPSTF, online September 12, 2017.
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