Three leading U.S. cancer groups have proposed new guidelines for cervical cancer testing for women, including when to start screening for sexually active young women, extending intervals between screenings and in some cases, supplementing the traditional Pap test with human papilloma virus (HPV) testing.

The American Cancer Society, the American Society for Colposcopy and Cervical Pathology and the American Society for Clinical Pathology joined to create the guidelines, which advise women to get fewer screenings over their lifetime and that women 65 and older with a history of normal Pap tests can stop altogether.

The guidelines also call for combination HPV-Pap testing in women aged 30 and older, placing stronger emphasis on HPV testing than another set of guidelines officially released at the same time, from an independent and influential government panel.

That government panel, the U.S. Preventive Services Task Force (USPSTF), is reaffirming the Pap test as the best way for women aged 21 to 65 to spot cervical cancer, saying it “substantially” cut the number of deaths from the disease.

The USPSTF remains cautious on the use of the human papillomavirus (HPV) blood test to detect cervical cancer. It moved against the use of the HPV test in women under the age of 30, and said that evidence was still lacking on its risks vs. benefits to recommend it in women aged 30 and older.

To compare the Pap against the HPV test, the researchers analyzed four studies they deemed of fair-to-good quality, encompassing nearly 142,000 women.
Dr. Elizabeth A. Poynor, a gynecologic oncologist and pelvic surgeon at Lenox Hill Hospital in New York City, said this is a work in progress. “We are still learning how to incorporate HPV testing into our current algorithm,” she said. “Women need to ask their physician which screening strategy is best for them based on their personal risk factors.”

Another review article looked at the appropriate ages to initiate and discontinue cervical cancer screening. The authors conclude that screening for cervical cancer should continue to begin at age 21. If a woman age 65 or older has had an adequate number of normal Pap test results and is not considered high risk for cervical cancer, she can stop screening at age 65. Older woman who are considered at high risk for cervical cancer include those who have had previous high-grade cervical lesions or a history of cervical cancer.

Dr Mark Wakabayashi, chief of gynecologic oncology at the City of Hope Cancer Center in Duarte, Calif., said that the real issue is that some women never get either test. “The ones who don’t get Pap tests are the ones who are dying from cervical cancer,” he said. “We are trying to be more cost-effective with our screening for cervical cancer, but we don’t want to mess with success.”

Ref: http://yourlife.usatoday.com/health/medical/story/2011-10-20/Cancer-groups-release-cervical-cancer-screening-guidelines/50837474/1