A big national gynecologists’ group has new guidelines out on when women should get a pap smear, the screening test that helps reduce the risk of cervical cancer. Guidelines like these come out all the time and go largely unnoticed by the public, but given the debate this week over the new mammogram guidelines, the pap test guidelines are getting some attention . The guidelines note that pap smears can lead to procedures that may increase the risk of premature delivery if a woman gets pregnant later in life. And, they note, cervical cancer is extremely rare in adolescents. So they advise waiting until age 21 to begin screening; earlier guidelines had recommended starting at 21 or three years after the start of sexual intercourse, whichever was earlier. Women in their 20s should be screened every other year, instead of every year, the guidelines say. Cervical cancer tends to be slow-growing, and the group says studies have suggested that annual pap smears “offer little advantage” over screening every two or three

years. The guidelines are from the American College of Obstetricians and Gynecologists , a professional society that’s not connected to the government. And the group says it’s just a coincidence that their guidelines are coming out a few days after the mammography guidelines. Meanwhile, the authors of those mammography guidelines tried to calm things down a bit yesterday. “The task force is not against women having mammograms in their 40s,” one of the authors of the guidelines told the WSJ . Women in that age group should consult with their doctors and decide for themselves whether to be screened, she said. The group’s original recommendation says roughly the same thing, but in more technical terms. “The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take into account patient context, including the patient’s values regarding specific benefits and harms,” the guidelines say. Image: iStockphoto

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Balancing Risks and Benefits of Pap Smears