Word: paps
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Dates: during 2000-2009
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Judging from the reaction to the new breast-cancer recommendations, that is proving to be a difficult reality for Americans to accept. But the task force's mammography advice probably marks the leading edge of similar recommendations to come. Already, new guidelines on Pap smear screening for cervical cancer have delayed the age at which young women should begin regular testing and reduced the frequency of testing in older women. Doctors are also questioning the usefulness of prostate-cancer screening among otherwise healthy middle-aged men, as studies begin to show that the test, which has many risks...
Since the 1970s, when Pap testing became a part of routine gynecological exams, the rate of cervical cancer in the U.S. has fallen more than 50% - in 1975 there were 14.8 cases per 100,000 women, and by 2006, only 6.5 per 100,000 women. But the cancer, which is primarily caused by infection with the sexually transmitted human papillomavirus (HPV), is rare among teens under 20. Only about 14 cases are reported each year in the U.S. in teenagers, compared with 123 cases among women ages 20 to 24, according to the Centers for Disease Control and Prevention...
...guidelines advise women between the ages of 21 and 30 to be screened once every two years for cervical cancer. In women over 30, the guidelines allow for three years between screenings, if patients have three consecutive normal Pap smears and no prior history of abnormalities. Between 65 and 70, women may stop have Pap smears altogether, if they have had three normal tests in a row and negative results over the last 10 years. However, women with HIV, previously abnormal Pap tests, or other problems that would suppress the immune system or increase the risk of aggressive cervical cancer...
Cervical cancer is slow growing - giving doctors time to find it - and studies show that among women in their 20s, the risk of developing cervical cancer does not increase by reducing the frequency of Pap tests to every two years. Although the HPV infection rate is high among sexually active teens and young adults, the virus is typically cleared by the woman's immune system within a year or two of infection. Few cases of HPV infection lead to cancer; when they do, the cancer may develop up to 10 to 20 years after exposure to the virus...
...change in Pap testing does not represent as monumental a shift as the USPSTF's new advice on mammography, since Pap testing of adolescents, while recommended, has not become as entrenched as mammography as a preventive tool. Still, both new sets of cancer screening guidelines exemplify an effort by leading medical organizations to base their advice on scientific data, rather than an assumption that more screening always leads to better prevention. "Physicians have a hard time letting go of screening tests that make them feel comfortable," says Dr. Karen Soren, director of adolescent medicine at New York Presbyterian Morgan Stanley...