Women have questions about more infrequent cancer tests




Posted on November 20, 2009 at 5:32 PM

Updated Friday, Nov 20 at 6:42 PM

DALLAS — New guidelines as to when and how often women should get pap smears has a lot of people speaking up.

The new recommendations, from the American College of Obstetricians and Gynecologists, say routine pap smears don't need to start until a woman is 21, and after that on alternate years.

Women over 30 can reduce the frequency of checkups to every three years following three consecutive clear tests.

Unlike the controversial recommendations about mammograms earlier this week, this time the panel is made up of doctors who actually treat patients. They have been studying this issue for years.

It's been a busy week for Dr. Liesl Smith, an OB/GYN at Texas Health Dallas. Many of her patients are confused about new recommendations in female cancer screenings.

"They are both pretty dramatic changes for some women and what they are used to and expecting," Dr. Smith said.

On Friday, the American College of Obstetricians and Gynecologists told women they no longer need an annual exam for cervical cancer.

While some doctors say that could reduce problems caused by excessive screenings, others worry that many women might neglect checkups with their gynecologist.

"I would be concerned that some women would look at these guidelines and think, 'I can just go every three years,' and that's not going to be the case for a lot of women," Dr. Smith said.

Doctors say there will always be exceptions, but Andrea Murry wonders if more young women like her might be the ones to pay the biggest price for reduced testing.

"I think it's very confusing," Murry said. "I've had friends that have had problems in their yearly checkups that have saved their lives."

Research shows only 0.1 percent of cervical cancer occurs in women under 21. Doctors believe that's because a young woman's immune system can fight off HPV before it causes cancer.

These guidelines don't come out of the blue. In 1980, The American Cancer Society followed Canadian guidelines that recommend fewer pap smears as well.

E-mail jstjames@wfaa.com