June 21, 2011 in Nation/World

Report finds overuse of cancer tests

Lauran Neergaard Associated Press
 
Guidelines

The American College of Obstetricians and Gynecologists recommend that:

• Routine Paps start at age 21.

• Most women in their 20s get a Pap every two years.

• Women 30 and older wait three years between screenings if they’ve had a negative Pap and negative HPV test, or three consecutive clear Paps.

• If a Pap is inconclusive at any age, HPV testing may help rule out who needs further examination and who can just repeat a Pap in a year.

• Anyone who’s been vaccinated against HPV, a relatively new vaccine, still must follow Pap screening guidelines for their age group.

• Higher-risk women need more frequent screening.

On the Web: The CDC has a brochure to help women understand their options for cervical cancer screening: http://tinyurl.com/6g8de6v

WASHINGTON – Too many doctors are testing the wrong women, or using the wrong test, for a virus that causes cervical cancer.

How often to get a Pap smear – and whether to be tested for the cancer-causing human papillomavirus at the same time – now depend on your age and other circumstances.

But a government study reports Monday that a surprising number of doctors and clinics aren’t following guidelines from major medical groups on how to perform HPV checks.

That wastes money and could harm women who wind up getting extra medical care they didn’t need, said Dr. Mona Saraiya of the Centers for Disease Control and Prevention, who led the research.

The findings, reported in the journal Obstetrics & Gynecology, show women have to be savvy to ensure they’re getting the right checkups – enough, but not too much.

“It’s extremely discouraging,” said Debbie Saslow, gynecologic cancer director at the American Cancer Society. “We have not been able to get that message across.”

Cervical cancer grows so slowly that Pap smears – which examine cells scraped from the cervix – usually find it in time to treat, or even to prevent when precancerous cells are spotted and removed.

For decades, Paps were the only way to screen for cervical cancer. Now doctors know that certain strains of HPV cause most cervical cancer.

The new CDC study, part of a national survey of medical practices that included 600 providers of cervical cancer screening, examined how doctors are using it.

The study found 60 percent of doctors and clinics say they give a routine Pap-plus-HPV test to women who are too young for that combination. Guidelines stress that so-called co-testing is only for women 30 and older.

Why the age limit? Saslow said HPV is nearly as common as the common cold, especially in younger women – but their bodies usually clear the infection on their own. Learning that a 20-something has HPV increases the odds of more invasive testing that in turn can leave her cervix less able to handle pregnancy later in life.

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