Local health experts offer views on new Pap test guidelines

Recommendation: Most women only need screenings every three to five years

Cindy Hadish
Published: October 24 2012 | 6:45 am - Updated: 1 April 2014 | 2:25 am in
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Women should have a conversation with their doctor about cervical cancer screenings, after another group recommended Pap tests be used no more than once every three to five years.

New guidelines issued Monday by the American College of Obstetricians and Gynecologists noted that women aged 30 to 65 who have always had negative tests can have a Pap test combined with HPV testing once every five years.

If HPV testing is unavailable, the recommendation for women in that age group is once every three years.

“I still advise every patient to get a gynecological exam every year,” said Dr. Brandon Bourgeous, a partner at Cedar Rapids Ob Gyn Specialists, 788 Eighth Ave. SE.

Pap tests are used as a tool to detect signs of cervical cancers and precancerous changes.

Bourgeous said he is moving towards advising women with no abnormal pap tests who are older than 30 to go up to five years between screenings.

Because risk factors differ among women, however, patients should discuss that with their doctor, he said.

For example, women who smoke are at a much greater risk of developing cervical cancer.

Most squamous cell cancers are related to human papillomavirus, or HPV, infections, for which a vaccine is now available, but Bourgeous said it could take a generation to see a noticeable decrease in cervical cancers.

Senior Clinician Sandy Ball said Planned Parenthood of the Heartland has been advising patients of the new recommendations since September, after the American Society for Colposcopy and Cervical Pathology released its guidelines.

“I still give them the option because it’s their health,” said Ball, a physician assistant at Planned Parenthood’s Iowa City clinic.

She said that while pap smears are not harmful, the follow-up treatment can be stressful and potentially affect a woman’s ability to carry a pregnancy to term.

Bourgeous added that women accustomed to being vigilant about Pap screenings might hesitate to have the test performed less often.

“It’s hard to let go of that notion that screening needs to be done more frequently,” he said.

The college noted that while common, most HPV infections don’t progress to cervical cancer and the majority of truly precancerous cervical cells take years to turn into invasive cervical cancer.

Monday’s guidelines align with recommendations from the American Cancer Society and other groups.

Women younger than 21 should not be screened for cervical cancer or HPV regardless of whether they are sexually active, according to the groups, because  invasive cervical cancer is very rare in women younger than 21. Also, the immune system, particularly in young women, effectively clears the HPV infection in an average of eight months.

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