It's uncanny: Once again, news about mammograms and Pap smears arrives in tandem. Reuters reports that the American College of Obstetricians and Gynecologists has published "new guidelines" on Pap smears, right on the heels of a New York Times report earlier this week on the frequency of misdiagnoses in early breast cancer screenings.
Late last fall, of course, controversial guidelines were issued that bumped up the suggested age for mammograms to 50; and soon thereafter, it was announced that women should hold off on Pap smears until age 21 and have them less frequently. Understandably, many women found the sudden reversal of screening dogma a tad disconcerting. The message about mammograms was communicated poorly by the U.S. Preventive Services Task Force; the American College of Obstetricians and Gynecologists chose an unfortunate time to announce its findings; and, for the most part, the media only added to the confusion.
So, let's be clear here: The Pap smear guidelines are not new. They are newly published in the journal Obstetrics & Gynecology, but they are fundamentally the same guidelines announced late last year: Young women should wait until age 21 to begin getting Paps, which can identify HPV infections that can lead to cervical cancer. (Previously, the guidelines suggested getting a first Pap within three years of becoming sexually active or by age 21.) Added to the recommendation is the caveat that "adolescents with compromised immune systems -- due to HIV infections, organ transplants or long-term steroid use, for instance -- should not wait until 21 to be screened," according to Reuters.
Just remember, the guidelines are based on the fact that women under 21 are at low risk for cervical cancer and that too-frequent testing can lead to unnecessary, and potentially destructive, treatment (which is the subject for a whole 'nother post). And, as always, you have to be your own advocate when navigating our gnarly healthcare system, especially when it comes to a disease that's caused by a (shhh!) sexually transmitted virus.