The U.S. Preventive Services Task Force recently recommended that healthy women younger than 65 need a Pap test only every three years.
The recommendation is meant to address the concern that many women were being tested too frequently, which could lead to over treatment of low-grade lesions that might not prove to be cancerous.
The task force found no direct evidence that annual screening achieves better outcomes than screening every three years. Studies suggested little added benefit of more frequent screening for most women.
In addition, too frequent screening can result in increases in cost and in women having needless anxiety because of false positive results.
The task force also recommended that screening begin for all women at age 21 regardless of their sexual activity levels. This was a change from the task force’s 2003 recommendation that screening should begin at age 21 or within three years of the initiation of sexual activity.
However, the US preventative task force is an independent agency who makes recommendations on evidence based medicine. This is similar to other agencies such as the World Health Organization, the Centers for Disease Control, the American Cancer Society, and numerous specialty colleges, such as the American College of Obstetrics/Gynecology (ACOG).
This current recommendation is consistent with ACOG’s recent recommendation, only more broad. ACOG recommends Pap tests every three years after 30, whereas the US Prevention Task force recommends three years in ALL women under 65.
I prefer ACOG’s guidelines because they are more specific and give clearer guidelines for screening intervals in the case of abnormal findings. Personally, I am going to give Pap screenings to women in their 20′s every two years. I would consider performing a yearly screening based on the patient’s lifestyle such as multiple partners. As a general rule I, and most all OB/GYNs will continue to follow ACOG’s recommendations despite subtle variances in the recommendations from other organizations.
