New cervical cancer screening guidelines arrive

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One of the great success stories in cancer research is the annual Pap test cervical cancer screenings introduced in the 1950. Since the introduction, cases of what was once the number one cancer in women have plummeted. Human Papillomavirus (HPV) vaccination has further reduced the numbers.

“Today, we know some cervical cancer can be prevented with proper screening to find pre-cancers before they develop into invasive cancer,” said Dr. Kevin Lee, PhD, Radiation Oncologist with Gadsden Regional’s Cancer Center. “If a pre-cancer cell is found, it can be treated, stopping cervical cancer before it really starts.”

One factor in cervical cancer is the prevalence of HPV in society. An estimated 80 percent of sexually active women will become infected with the virus at some point, but of the more than 100 strains of HPV identified, only a few high-risk strains are connected to cervical cancer. The vast majority of HPV infections resolve without any treatment or intervention.

The Centers for Disease Control and Prevention recommends young women and men receive HPV vaccination at 11 or 12 years of age to provide the best protection long before the start of any sexual activity.

Catch-up vaccines are recommended for males through age 21 and for females through 26 years of age. In females, vaccination helps protect against two types of HPV that cause 70 percent of cervical cancer cases.

“Unfortunately, the CDC reports more than 4,000 U.S. women still die from cervical cancer every year,” said Dr. Xavier Smith, OB-GYN with Women’s Health Partners. “Women at risk of dying from the disease today are those who have been screened infrequently – or not at all.”

The recent change in guidelines about screening frequency have created confusion. What used to be a clear direction from the American Cancer Society – “get a yearly Pap test” – has become less clear.

Recommended time between screenings is now longer, and two separate tests are available. According to guidelines:

  All women should begin cervical cancer screening via a Pap test at age 21.

● Women between the ages of 21 and 29 should have a Pap test at least every three years. HPV testing should be done only if needed after an abnormal Pap test.

● Women between the ages of 30 and 65 should have both a Pap test and an HPV test at least every five years.

● Women over 65 who have had regular screenings with normal results should not be screened for cervical cancer.

● Women who are at increased risk for cervical cancer may need to increase the frequency of these screenings. Notably, African American and Hispanic women have a higher incidence of cervical cancer than other ethnic groups.

The American Cancer Society no longer recommends getting a Pap test every year, because it usually takes longer than that (10-20 years) for cervical cancer to develop. As the debate continues, there is also the option to have a separate test for HPV alone.

Discuss with your doctor the appropriate actions based on your age, lifestyle and risk factors.

Submitted by Gadsden Regional Medical Center

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