We have all heard that “screening saves lives,” but are health care providers screening for certain cancers too often?
The clinical guidelines recommend screening low-risk women for cervical cancer—with or without the complement of a human papillomavirus (HPV) test — every three years after age 30, but most primary care clinicians report they advise testing for the disease far more often, according to a report in the June 14, 2010 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Mona Saraiya, M.D., M.P.H., of the Centers for Disease Control and Prevention in Atlanta, lead author of the study, says there is no question that annual Papanicolaou (Pap) testing has helped decrease the burden of cervical cancer in the United States, according to background information in the article. But not everyone agrees that screening annually benefits low risk women.
The U.S. Preventive Services Task Force has long recommended extending screening intervals up to every three years, citing evidence that screening annually does not improve outcomes when compared with screening every three years.
Other guidelines, including those of the American Cancer Society (ACS) and American College of Obstetrics and Gynecology (ACOG), have traditionally recommended that women have three annual normal Pap tests before switching to less frequent screening. However, improved understanding of HPV infection and its cervical cancer role, along with the introduction of HPV testing, have recently resulted in stronger recommendations from ACS and ACOG to extend screening intervals without requiring prior normal Pap tests.
“Cost-effectiveness and other studies evaluating combining HPV and Pap tests in the United States and elsewhere, have concluded that lengthening screening intervals is a fundamental assumption and advantage of combining HPV and Pap testing," the authors wrote.
While combining HPV testing with cervical cancer screening may be a more precise indicator of cervical cancer risk, the researchers found doctors were still testing annually.