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."
The American Cancer Society provides more information on cervical cancer screening.
SOURCES: Evelyn P. Whitlock, M.D., MPH, preventive medicine specialist, Kaiser Permanente Center for Health Research, Portland, Ore.;
Mark Wakabayashi, M.D., chief, gynecologic oncology, City of Hope Cancer Center, Duarte, Calif,;
Elizabeth A. Poynor, M.D., gyneco
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