Pap smears guidelines may change

Women may no longer need annual pap smears.

New guidelines from the U.S. Preventive Services Task Force, an independent advisory panel for clinical services, and the American Cancer Society, along with two other medical societies, recommend that healthy women ages 21 to 29 only need cervical cancer screenings every three years.

It is the first update for screenings since 2003. In 2009, the American College of Obstetricians and Gynecologists recommended annual pap tests for women younger than 21.

Women who have had the HPV vaccine, Gardasil or Cervarix, still should have pap smears every three years, according to the recommendations, because not all types of cervical cancers are prevented by the vaccines.

The guidelines also recommend that women ages 30 to 65 have cervical cancer screenings along with HPV testing every five years instead of a screening every three years. This is the first time “co-testing” has been recommended for women.

Right now, private insurance plans and Medicare pay for annual pap smears.

But Jyll Hopkins, women’s health nurse practitioner at Southern Indiana Physicians for Women in Bloomington, said insurance companies will probably begin covering what is now recommended.

“It’s going to get to the point where they’ll say, ‘Why did you give a pap to this patient, it’s an unnecessary screening,’” Hopkins said.

Unnecessary screenings and pap smears for women, especially those younger than 21, can lead to more harms than benefits. Although there is little evidence for why cervical cancer screenings can be harmful, Hopkins said, any procedure comes with risks.

Surgical procedures which can sometimes follow pap screenings that do not appear to be normal can harm a woman’s child-bearing abilities, Hopkins said. She said women should still be screened.

A recent study published in the Milbank Quarterly, a journal that publishes research and policy review, found that the rate of cervical cancer rates were the same in the United States as in the Netherlands even though women in the U.S. had four times as many pap smears.

Junior Lauryn Roberts, 21, said she had been given multiple reasons by clinics for being denied a pap smear.

“I was told I couldn’t have one because I hadn’t been sexually active long enough and, the second time, because I wasn’t 21,” she said. “Either way, I wanted to be reassured there was nothing wrong, and they weren’t able to give me that.”

Hopkins said the new recommendations might be hard to follow for older patients.

“It’s just a habit that women have always been told that they need a pap every year so it’s just a challenge,” she said. “That’s what they’ve been doing for quite a few years.”