Update of Previous USPSTF Recommendation
It seems that just about the time that we get patients educated about the recommendations regarding Paps, they change it. When I was younger, it was expected to have the test done on a yearly basis if you were sexually active. You played, you paid! No one likes having the test done of course.
There are some valid points to the new study regarding the fact that we may be more aggressively treating the cervix by doing invasive studies and damaging women's reproductive potential. The time frame is being recommended to push to three year increments for screening if there is no particular history of issues. I am still not quite sure about the recommendation of pushing to 5 years though. I feel that there is a higher risk of missing vulvular cancers if we go that far out, especially in older women. They already feel that once they get beyond the age of 65 the need for an exam is over.
Do you think that insurance companies are pushing this in order to keep from paying out for procedures they feel is unnecessary? What about the women that have aggressive cervical cancer that may have been detected and wasn't? Should we be better safe than sorry? Read the below recommendations and tell me what you think?
This recommendation updates the 2003 USPSTF recommendation on screening for cervical cancer. It differs from the previous recommendation in that it recommends cytology screening every 3 years among women age 21 to 65 years. In addition, this recommendation includes more guidance on the appropriate age ranges and frequency of screening, including a new recommendation that women younger than age 21 years not be screened because the evidence shows no net benefit. The previous recommendation suggested that most of the benefit of screening could be obtained by beginning screening within 3 years of onset of sexual activity or age 21 years (whichever comes first) and screening at least every 3 years. This recommendation reaffirms the previous recommendations against screening in adequately screened women older than age 65 years and in women who have had a total hysterectomy with removal of the cervix. The current recommendation includes new evidence on the comparative test performance of liquid-based versus conventional cytology that indicates no substantial difference in test performance (that is, relative detection or absolute sensitivity or specificity) for detection of CIN2+/CIN3+. It also includes more guidance on the appropriate use of HPV testing in cervical cancer screening, including a new recommendation that women younger than age 30 years not be screened with HPV testing. The USPSTF found new evidence that addressed the gaps identified in the previous recommendation and allowed the USPSTF to recommend HPV testing combined with cytology as an acceptable screening strategy for women age 30 to 65 years who prefer to lengthen their screening interval beyond 3 years.