Important note: Information in this article was accurate in 2009. The state of the art may have changed since the publication date.
Washington Post (11.20.09) - Friday, November 20, 2009
Rob Stein
"We really felt that the downsides of more frequent screening outweighed any benefits," said Alan G. Waxman, an OB/GYN professor at the University of New Mexico who led ACOG's revision. "More testing is not always more intelligent testing."
Under prior guidelines, women were to start annual cervical screening within three years of becoming sexually active. Now ACOG says women can wait to start until age 21, regardless of age at sexual debut. Women younger than 30 can be rescreened once every two years rather than annually, and women age 30 and older whose previous three tests are negative can be rescreened every three years, ACOG says. Women at increased risk, however, should continue to be screened more frequently, it said.
Annual testing for low-risk women could precipitate unnecessary stress, anxiety, and potentially harmful interventions - all to treat growths that would not necessarily cause problems, ACOG found. HPV is not unusual among sexually active young girls and women, and because the cervix is immature, their incidence of precancerous lesions is higher. Nonetheless, HPV infection clears within one to two years among most adolescents, and the large majority of cervical dysplasias among adolescents resolve on their own, ACOG said.
Cervical cancer is very rare in women under age 21, ACOG said. And the cancer grows relatively slowly, so waiting until age 21 to screen would not pose a significant risk, the organization concluded.
The new guidelines are published in ACOG Practice Bulletin (2009;109).
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