Navigation Links
Outdated practice of annual cervical-cancer screenings may cause more harm than good

For decades, women between the ages of 21 and 69 were advised to get annual screening exams for cervical cancer. In 2009, however, accumulating scientific evidence led major guideline groups to agree on a new recommendation that women be screened less frequently: every three years rather than annually.

Despite the revised guidelines, about half of the obstetrician-gynecologists surveyed in a recent study said they continue to provide annual exams an outdated practice that may be more harmful than helpful, said Drs. Russell Harris and Stacey Sheridan of the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill.

"Screening is not the unqualified good that we have advertised it to be," they wrote in an editorial titled, "The Times They (May Be) A-Changin': Too Much Screening is a Health Problem." The editorial accompanied a research study reviewing physician practices around cervical-cancer screening and vaccination for human papilloma virus (HPV), which has been linked to cervical cancer.

The study, "Physicians Slow to Implement HPV Vaccination and Cervical Screening Guidelines," was published July 9 in the American Journal of Preventive Medicine.

"Screening for cervical cancer and other cancers such as breast and prostate, has clear potential for harms as well as benefits, and these must be carefully weighed before a rational decision about screening can be made," wrote Harris and Sheridan, who are professor and assistant professor of medicine, respectively, at UNC's School of Medicine. They also hold adjunct appointments at UNC's Gillings School of Global Public Health.

The study noted physicians said they were comfortable with longer testing intervals, but were concerned their patients might not come in for annual check-ups if Pap tests, the screening test for cervical cancer, were not offered. The problem, Harris said, is that annual Pap tests produce more abnormal results leading to additional, invasive testing that itself bring risks.

"Many women have 'abnormal' [Pap test] findings that are not cancer, but may be a 'cancer precursor.' We know that the great majority of these abnormal findings would never progress to actual invasive cancer, yet these women are referred" for further, more invasive testing, Harris said.

One such test, called a "colposcopy," [cohl-PAH-scoh-pee], involves examining the cervix for possibly cancerous lesions, followed frequently by a biopsy, i.e., taking a small sample of the lesion, which can cause pain and bleeding, as well as potential psychological harm. "The screening test itself can raise concern about dreaded cancer; a positive screening test heightens this worry; finding a cancer precursor, even one of uncertain importance, just increases worry further," they wrote.

The authors recognize the important benefit of screening for cervical and other cancers, but "screening every three years [for cervical cancer] retains about 95 percent of the benefit of annual screening, but reduces harms by roughly two-thirds." Less-frequent screening also reduces costs significantly in terms of patient and physician time and laboratory testing supplies and other resources.

The newest cervical-cancer and HPV screening recommendations were released in March 2012, too recent to have been included in the July 9 study. Women should still begin Pap tests at age 21 and every three years afterward, but women between the ages of 30 and 65 may choose to extend the Pap test interval to every five years, provided they also get an HPV test, according to the U.S. Preventive Services Task Force and the American Cancer Society, among others. However, the authors added, "the debate about a do-less approach to screeningfor cervical cancer and other conditions as wellis ongoing."

The editorial concluded: "Bob Dylan sang about changing times before they actually changed, yet his singing moved the public discussion in a positive direction. Our sense is that the right song for the current discussion is about helping people come to appreciate the harms screening does and move us toward a better balance of benefits and harms."


Contact: Kathy Neal
University of North Carolina at Chapel Hill

Related medicine news :

1. Doctors Detail High Costs of Fighting Malpractice Claims
2. Blending conference translates substance abuse research into practice
3. AGA releases first independently developed ABIM-approved Practice Improvement Module in GI
4. Simulation technology allows users to safely practice phacoemulsification cataract surgery
5. Meditation practice may decrease risk for cardiovascular disease in teens
6. Meditation practice may decrease risk for cardiovascular disease in teens
7. Alex Galindo, Attorney and Partner at Curd, Galindo & Smith, LLP, Court Wins Against the County of Riverside's Motion to Dismiss Medical Malpractice Case
8. IU gastroenterologist develops practice guidelines for most prevalent liver disease
9. AIUM and AUA guideline development leads to practice accreditation for urologic ultrasound
10. CWRU nurse researcher surveys infection control practices for home patients
11. E-Records Linked to Fewer Malpractice Claims
Post Your Comments:
(Date:6/25/2016)... Beach, CA (PRWEB) , ... June 25, 2016 , ... ... UCLA with Magna Cum Laude and his M.D from the David Geffen School of ... Diego and returned to Los Angeles to complete his fellowship in hematology/oncology at the ...
(Date:6/25/2016)... ... 25, 2016 , ... On Friday, June 10, Van Mitchell, Secretary of the ... to iHire in recognition of their exemplary accomplishments in worksite health promotion. , The ... Health & Wellness Symposium at the BWI Marriott in Linthicum Heights. iHire was one ...
(Date:6/24/2016)... , ... June 24, 2016 , ... A recent ... most people are unfamiliar with. The article goes on to state that individuals are ... many of these less common operations such as calf and cheek reduction. The Los ...
(Date:6/24/2016)... ... June 24, 2016 , ... June 19, 2016 is World Sickle Cell Observance ... and the benefits of holistic treatments, Serenity Recovery Center of Marne, Michigan, ... Disease. , Sickle Cell Disease (SCD) is a disorder of the red blood cells, ...
(Date:6/24/2016)... Texas (PRWEB) , ... June 24, 2016 , ... ... International Conference and Scientific Sessions in Dallas that it will receive two significant ... of the grants came as PHA marked its 25th anniversary by recognizing patients, ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... INDIANAPOLIS , June 23, 2016 Roche ... received 510(k) clearance for its Elecsys BRAHMS PCT (procalcitonin) ... severe sepsis or septic shock. With this clearance, Roche ... provide a fully integrated solution for sepsis risk assessment ... associated with bacterial infection and PCT levels in blood ...
(Date:6/23/2016)... -- Research and Markets has announced the addition ... to their offering. The ... commercial environment for MedImmune to enter. The US ageing population ... to drive considerable growth for effective anti-influenza medications. The introduction ... considerably, but development is still in its infancy. ...
(Date:6/23/2016)... INDIANAPOLIS , June 23, 2016 If ... Leaders Scholarship is any indication, the future is in ... at by the Diabetes Scholars Foundation ... the way of academic and community service excellence. ... since 2012, and continues to advocate for people with ...
Breaking Medicine Technology: