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."
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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