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New Pap Test Guidelines: Start Later, Have Fewer
Date:11/20/2009

, recommending it, for instance, to virgins although most cervical cancers occur as a result of HPV, a sexually transmitted virus. In a survey of more than 1,200 doctors, just 21 percent of general practice doctors, 16 percent of gynecologists and 28 percent of internists followed Pap test recommendations.

What do other practicing physicians think of the new guidelines, which are published in the December issue of Obstetrics & Gynecology?

They make sense to Dr. Mark H. Einstein, a gynecologic oncologist and director of clinical research at Montefiore Medical Center in New York City. The decision to delay Pap testing until age 21 might help minimize anxiety in younger women found to have HPV, he said. Most abnormalities found by very early Pap tests "will go away on their own," he said.

But Einstein stressed that the guidelines are just that: guidelines. A physician must take patient risk into account and decide the best schedule on an individual basis, he said.

And, he said, "it is still important for young women to be coming in regularly for sexually transmitted disease testing."

Dr. Ernest Han, a gynecologic oncologist and assistant professor at the City of Hope Comprehensive Cancer Center in Duarte, Calif., said that "as more studies are coming to light, I think we are seeing a trend toward targeted screening, eliminating some."

And he agreed with Einstein: "The guidelines are just guidelines. You have to look at the individual and her risk factors, her behavior, [whether] she had an abnormal Pap in the past."

More information

The American Congress of Obstetricians and Gynecologists has more on Pap tests.



SOURCES: Alan G. Waxman, M.D., professor, obstetrics and gynecology, University of New Mexico, Albuquerque, N.M.; Ernest Han, M.D., Ph.D.,
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