Why the New Cervical Cancer Screening Guidelines Are a GOOD Thing

Just a few days after the controversial new breast cancer screening guidelines were released, the American College of Obstetricians and Gynecologists (ACOG) has come out with its revised guidelines for cervical cancer screening. Previously, ACOG had recommended that women get annual pap smears starting at age 18 or when they started having sexual intercourse; the new guidelines call for pap smears starting at age 21 or three years after initial sexual intercourse. In addition, women in their twenties with a normal pap smear can wait two years between tests.  Healthy women in their thirties now need only get tested every three years.

At first, this seems eerily similar to the new mammogram guidelines. Both mean less frequent cancer screening for women. Naturally, women who are still reeling from the suggestion that they cut back on breast cancer screening are suspicious. However, when you examine the issue closely, it is clear that these new guidelines are quite different. For starters, the new cervical screening recommendations are based on actual science and medical results, not some vague notion that women need to be saved from stress.

According to the ACOG, only 0.1 percent of cervical cancer occurs in women under 21 years of age. This is due, at least in part, to the fact that young women have stronger immune systems that are usually able to fight off HPV -- a sexually transmitted disease linked with cervical cancer -- before it causes cancer. Up to 90 percent of HPV infections in adolescents clear up on their own. Moreover, the procedure to remove precancerous tissue caused by HPV can scar the cervix and complicate any future pregnancies. Women who've had the procedure are at an increased risk for needing a Cesarean-section, and approximately one in 18 women who've had the procedure will go on to give birth prematurely.

For most doctors, the only real concern is that women will interpret the new screening guidelines as a reason not to get an annual exam, which the ACOG still recommends. Without the need for an annual pap smear serving as motivation, some experts fear that that young women will skip their exams altogether, missing out on STD testing, preventative care, and contraceptive counseling.

While the reduction in mammogram frequency appears to have sprung from a misguided need to protect women's emotions, the reduction in pap smear frequency is rooted in the need to protect women's bodies. This is truly a case of less being more.

Clearly, well-woman visits are an important habit to instill in young women, but I'd argue that to achieve that goal we need better educate adolescent girls on the importance of sexual and reproductive health, not lure them in for tests they don't need. Surely we can come up with a better plan than medical bait-and-switch.  Hopefully, gynecologists will educate their patients on the reasoning behind the changes and on why it is still vital that they maintain yearly check-ups. After all, a woman informed about her reproductive health is an empowered woman.

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