Docs: Less frequent Pap tests recommended

Tampa, Florida --  The Pap smear has saved the lives of countless women, contributing to a fifty percent decline in cervical cancer rates in the last thirty years.

Cervical cancer is often caused by certain strains of the human papillomavirus (HPV), a common sexually transmitted disease.

"I can't think of another test that has done more for the prevention of cancer than the Pap smear," said Dr. Jill Hechtman, OB/GYN with St. Joseph's Women's Hospital.

But, what women have long been told about the screening is changing.

On Friday, the American College of Obstetricians and Gynecologists announced a change in guidelines, recommending women get the tests less often and delay their first screening until age 21, regardless of when they become sexually active.

Read the ACOG News Release

Women ages 21-30 are now advised to get the screening every two years, rather than annually.  Women older than thirty can go for their pap every three years if they've had three consecutive normal pap results.

'The tradition of doing a Pap test every year has not been supported by recent scientific evidence," says Alan G. Waxman, MD, at the University of New Mexico, "A review of the evidence to date shows that screening at less frequent intervals prevents cervical cancer just as well, has decreased costs, and avoids unnecessary interventions that could be harmful."

ACOG says women who will still need more frequent tests include those who have certain risk factors such as HIV, are immunosuppressed, were exposed to diethylstilbestrol (DES) in utero, and have been treated for cervical itraepithelial neoplasia (CIN) 2, CIN 3, or cervical cancer.

The latest recommendations come on the heels of women being told they do not need to go for their first mammogram until age 50, rather than age 40.

Read:  Breast 'awareness' trumps self-exams, docs say 

While the change in guidelines is new to most women, it is nothing new in the medical field where it's been discussed for years.

ACOG says the changes are a result of studies that shows younger women infected with HPV, often clear the infection and the cervical dysplasia caused by the virus, on their own.  Treating the cervical dysplasia in teenagers can lead to economic, emotional and future childbearing implications, according to ACOG.

"Screening for cervical cancer in adolescents only serves to increase their anxiety and has led to overuse of follow-up procedures for something that usually resolves on its own," said Dr. Waxman.

The guidelines for pap tests may be changing, but Dr. Jill Hechtman says this doesn't mean women can skip their annual exams all together.

"When you go to the doctor, you go for other reasons than the Pap, you go for an annual pelvic exam, a breast exam, blood pressure check, you can have STD's screened," explained Dr. Hechtman.

"It raises concern to me that patients are going to misconstrue the information they're given and we're going to have trouble getting them into our offices," she added.

That's only one of her concerns.  While there are no indications insurance companies will change coverage policies as a result of the guideline changes, Dr. Hechtman says that doesn't mean it won't happen.

"Insurance companies base their re-imbursements, their paying for tests, based on these global statements.  Well, medicine isn't black and white, it's gray," she said, "My concern is these patients won't get the care they need and they're going to be missed."

She says they'll do what they can to ensure insurance companies cover the costs for women who do not fall into the broad category.