New guidelines indicate annual Pap tests unnecessary

Women may sigh in relief because they won't have to make the yearly trek to the gynecologist or family practitioner for a Pap test any longer. New information from medical groups states that by having pap smears in combination with a human papillomavirus (HPV) test, many women can safely spread out testing by five years.

Recently, advice on having cervical cancer screenings has varied from medical expert to medical expert. Many advise women to get screened every one to three years. Now the U.S. Preventative Services Task Force, which published a new set of guidelines in the Annals of Internal Medicine, state that by undergoing both a Pap smear and an HPV test together, which has been dubbed "co-testing," women ages 30 to 65 who have had negative results can wait another five years before the next test. The American Cancer Society is another organization issuing these revised guidelines. Experts advise that this is the first time that co-testing has been suggested and widely pushed, although some doctors have been doing co-testing on their own for years.

The change was based on information that showed more frequent testing for cervical cancer did not dramatically lower the numbers of those at risk. Although the tests are safe, fertility risks abound if further testing and procedures are done as the result of a positive Pap test, which can sometimes be inaccurate. Researchers have also found that many cases of cervical cancer are linked to HPV. Because cellular changes triggered from HPV are slow-moving, it is not vital to have annual testing. It is possible to find and treat the cancer before it becomes dangerous, even if 10 years have passed, says George Sawaya, M.D., professor in the University of California, San Francisco, Department of Obstetrics, Gynecology and Reproductive Sciences.

Although the guidelines are in place, many women may continue to have annual Pap smears, particularly because they are used to them and don't want to risk their health. Those who do not rely on their gynecologists as their primary care providers may be more apt to wait longer intervals between testing.

The Pap smear is named after George Papanicolaou, a Greek doctor who created the test in 1943 and suggested it could provide crucial early detection of cervical and uterine cancer. Pap tests became routine in 1955 and have reduced cervical cancer deaths by around 75 percent.

Women who are uncertain about waiting longer than a year between Pap tests can discuss their concerns with their gynecologists or family doctors. Together they can weigh the pros and cons of adopting a new schedule for cervical cancer screenings.