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Study: Annual Cervical Cancer Screenings May Cause More Harm Than Good

Clinicians ignore recommendation for screening every 3 years (July 9)

For decades, women between the ages of 21 and 69 were advised to get annual screening exams for cervical cancer. In 2009, however, accumulating scientific evidence led major guideline groups to agree on a new recommendation that women be screened less frequently: every 3 years rather than annually.

Despite the revised guidelines, about half of the obstetrician–gynecologists surveyed in a recent study said they continue to provide annual exams — an outdated practice that may be more harmful than helpful, said Drs. Russell Harris and Stacey Sheridan of the University of North Carolina at Chapel Hill.

“Screening is not the unqualified good that we have advertised it to be,” they wrote in a recent editorial, which accompanied a research study reviewing physician practices around cervical cancer screening and vaccination for human papilloma virus (HPV). The study was published July 9 in the American Journal of Preventive Medicine.

The study noted that physicians said they were comfortable with longer testing intervals, but were concerned their patients might not come in for annual check-ups if Pap tests were not offered. The problem, Harris said, is that annual Pap tests produce more abnormal results leading to additional, invasive testing that itself brings risks.

“Many women have ‘abnormal’ [Pap test] findings that are not cancer, but may be a ‘cancer precursor.’ We know that the great majority of these abnormal findings would never progress to actual invasive cancer, yet these women are referred” for further, more invasive testing, Harris said.

The newest cervical cancer and HPV screening recommendations were released in March 2012, too recent to have been included in the July 9 study. Women should still begin Pap tests at age 21 and every 3 years afterward, but women between the ages of 30 and 65 may choose to extend the Pap test interval to every 5 years, provided they also get an HPV test, according to the U.S. Preventive Services Task Force and the American Cancer Society, among others. However, the authors added, “the debate about a do-less approach to screening — for cervical cancer and other conditions as well — is ongoing.”

Source: University of North Carolina; July 9, 2013.

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