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Reuters
Certain types of cervical abnormalities that can lead to cancer may be missed when young women go years between Pap smears, a new study suggests.
Last year, the government-backed U.S. Preventive Services Task Force said women under 21 don't need to be screened for cervical cancer and Pap smears can be done once every three years after that.
Those guidelines broadly agreed with others released by the American Cancer Society, the American Society for Colposcopy and Cervical Pathology and the American Society for Clinical Pathology.
The new study's lead author, Dr. Lisa Barroilhet, said she agrees with those recommendations and that her findings are "absolutely" not a reason to change them.
"Any time you have new guidelines, you just want to make sure you're not assuming this is going to be the right thing long term for every patient," Barroilhet, from the University of Wisconsin Hospital in Madison, told Reuters Health.
She and her colleagues reviewed the records of 242 women with adenocarcinoma in situ, or AIS - cervical abnormalities that can lead to adenocarcinoma, one form of cervical cancer.
Those cancers occur further up the cervix than the squamous cell carcinomas typically caught by Pap smears, Barroilhet explained - so they're not the focus of Pap-related guidelines.
However, she and her colleagues found most young women in their study were diagnosed with AIS because of other abnormal lesions picked up on Pap smears that led to more testing and biopsies.
That was the case for 16 of the 17 women diagnosed with AIS before age 21, they wrote Thursday in Obstetrics & Gynecology.
Even though Pap smears weren't designed to catch adenocarcinoma precursors, the findings mean less-frequent Paps could lead to more of those full-on cancers developing, Barroilhet told Reuters Health. That's especially a concern because adenocarcinomas can be faster growing than squamous cell carcinomas, she said.
But Rebecca Horvat, a pathologist from the University of Kansas Medical Center representing the American Society for Clinical Pathology, said most abnormal lesions still take years to develop into adenocarcinoma.
"It doesn't go, as soon as you get it, you get a cancer," Horvat, who wasn't involved in the new study, told Reuters Health. "It can easily be picked up every three years."
She said the main challenge with moving to screening every three years may be a psychological one for women who have spent years getting their annual Pap.
The American Cancer Society estimates 12,340 U.S. women will be diagnosed with cervical cancer in 2013. Up to four times as many may develop AIS.
Because both adenocarcinomas and squamous cell carcinomas can be caused by human papillomavirus, or HPV, Barroilhet said preventing the sexually transmitted infection remains a public health priority.
"The best way to prevent any of this is HPV vaccination," she said.
Leave a Comment:
Oh, so it's okay that you have cancer for three years without knowing about it. Sorry, the "study" of less-is-more for the screening against cancer is just plain bogus. Ladies, get your pap smears regularly. Don't let these crap studies endanger your lives. A screening is well worth the effort. If it's a false positive, I'd rather just double check than RISK MY LIFE, that it's not. Too much emphasis is put on the "psychological damage" of pap and mammography screenings. If you choose not to look after yourself, who else will? I'd rather have a little "psychological" damage than be dead of cancer.
Cervical cancer was exceptionally rare even before the test was invented. This cancer is caused by HPV. If you have a negative HPV test your chances of getting cancer are zero. Fear mongering does not help the situation. Money needs to be spent on the vaccine and less testing for a rare cancer.
Hi Rogue,
I had cervical cancer. I survived and was so lucky to have a baby girl after. I wanted to let you know that HPV is not the only cause of cervical cancer. Nor is the HPV vaccience 100% effective against protecting women from all forms of HPV including the ones that it is intended to protect against. There are at least 3 forms of high risk HPV that the current vaccience does not protect against.
I just don't want your post to miss-inform young women like myself. Women should listen to their body and their gut, your doctor doesn't always know best. And you should get a pap once a year even if you have had the HPV vacciene.
NOBODY knows your body better than you. Don't listen to these studies or what is supposed to be in your best interest. If you have any doubts - do it. Get tested or get dead... don't take chances or ignore how you feel, what you feel or what your intuition is telling you!
Correct me if I am wrong, but didn't one of the Liberal Socialist Demoncrat sponsored Death Panels determine that just within the past year or two that Pap smears were being done too often as were Prostate exams? I'll tell you from my medically trained heart that personally I would NOT listen to these Government sponsored and paid for Panels and their advice. They'll just kill you...Also I beleive the Chant of the Cancer groups a couple of years ago was "early detection saves lives" so if your health plan is using the Government sponsored Death panels advice to stop routine Pap Smears or Prostate Tests, I would spend the money out of my own pocket, which I do, generally about under $100, for me a PSA is only $42 via my Doctors Lab, and get the tests done.
I've had a clear cell cancer and it was caught by a pap smear,then a biopsy to conclude that it was cancer.I was in my mid 20's and am pushing 62.I used to go every 3 months for a year and then twice a year.I had surgery and can't have children but I am alive.All women should go every year especially if they are sexually active and of child bearing years.They should also be screened for STD"s even if they believe that they are in a monogamous relationship.
Okay, the reason that Pap smears are only recommended for every three years is not because the Obama Death Panel wants to kill young wimmen. Supposing that you have a patch of abnormal, "precancerous" but harmless cells, one of three things can happen. They can stay that way forever, they can get better and vanish on their own, or they can turn into cervical cancer over time. Removing those that don't go away is valuable, because it greatly reduces the risk of death from cervical cancer.
Supposing that a particular person's abnormal cells are destined to develop into life-threatening cancer, that process usually takes several years. You do not have to find them within months of their first appearance or diiiie. Next year will be fine. So very few women are harmed by longer screening intervals. Supposing that these cells are not destined to become cancer, waiting longer between screens gives you a better chance that they will go away before you are screened again. This is a real benefit, not only because of the psychological and economic harm of being overdiagnosed, but because the surgery to remove such cells weakens a woman's cervix and increases her later risk of miscarriage. Overtreatment of cervical precancer causes far less direct physical harm than overtreatment of breast and prostate cancer, but it needlessly costs a few women their fertility. Recommendations for screening frequency therefore try to find the sweet spot at which the benefit done by screening is expected to outweigh the harm done. As some medical columnist once put it, there is nothing magical about the time it takes the earth to travel around the sun once. Annual screening may be best in some cases, but there is no rational reason to assume it is always best.
Several years, huh? My hysterectomy was Tuesday (March 26th). My first sign of anything wrong was less than four months ago. Before you go around spouting political garbage and such, you should try walking in our shoes for a while.
For tonight, I am not walking. I am in a lot of pain and feel like crap...but I will live.
I saw my mom go through cerivical cancer when I was 13 she was just 33. I get checked every summer Im not going to stop just because someone says Im low risk. I also have a sad known afact that I was born with HPV. SO yeah I get checked every year. My mom servived but now she has no right kidney and all sorts of scar tissue.
I was diagnosed with AIS 7 years ago. I had not had a pap smear in two years when I showed some symptoms that made me make an appointment. I was diagnosed one month after I first noticed something was off. After my surgery I was told by my oncologist to have a pap smear every 3 months for half a year and then every 6 months for 3 years. After that I was released to a normal schedule of once per year. I can tell you I would never miss that annual appointment! I am a strong proponent of an annual appointment as well as listening to your body and your gut. Get to know what is normal for you so you can recognize when something is wrong. If you have irregular bleeding or pain during intercourse make an appointment immediatly. The HPV vacciene does not protect against all forms of high risk HPV, nor is it 100% effective at preventing the forms that it is supposed to protect against. More over, HPV is no the only cause of cervical cancer. Other causes exist and are not widely understood. The bottom line is make your annual appointment. Doctors don't always know whats best for you, your body communicates and your gut will never lead you wrong! Wishing you all health, and take care of your selves :)