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Annual Pap Tests Often Ordered But Unneeded: Study
Date:8/18/2011

gative HPV test and two consecutive normal Pap tests. In the third, she had a current negative HPV test and no Pap history besides the current one.

While all three scenarios would warrant recommending an interval of three years, most of the doctors and others who performed the tests still would recommend yearly screening, the investigators reported.

"We found that only half the providers are using the HPV co-test," Roland said. She couldn't explain why that is so, or why they continue to order annual screens even if they perform both tests as advised.

Among the study limitations, however, is that office staff often answered the questions, which may have affected the accuracy, the study authors said.

A conventional Pap test costs about $14, Roland said, and a liquid-based cytology type test is about $28. The cost of the HPV test varies, she noted.

The findings puzzle Dr. Elizabeth Poynor, a gynecologic oncologist and pelvic surgeon at Lenox Hill Hospital in New York City. "What struck me was the slow nature of the physicians to accept the new guidelines," Poynor said.

But, she pointed out that the HPV co-test was new when the data was collected in 2006. Today, more doctors could be using the test and extending the interval between screenings. Maybe doctors need to get used to the guidelines, to develop a comfort level with the less frequent screening, she said.

The guidelines make sense, Poynor added. "When you combine a negative HPV and a negative Pap, the false negative rate goes down to a very low level," she said.

Women can take this information to their doctors and "use it as a point for dialogue or discussion," Poynor suggested.

However, it's crucial to realize that the screening guidelines apply only to women 30 to 60 who are healthy, Poynor stressed. They don't apply to women with certain medical risk factors, such as exposure to the prescription drug DES (diethylstilbestrol), which has been linked t
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