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I've already commented on the startling national results that claim that one in four teenage girls have an STD. But now a new question is being raised about young women's sexual health because of new Pap smear guidelines.
Prior to the new guidelines, women were told to begin getting pap tests three years after becoming sexually active or when they turned 21. Pap smears look for signs of cervical cancer, namely, they detect abnormal cells in the cervix. Catching the cells early on allows them to be removed before they become cancerous. But new guidelines have changed things up. The guidelines continue to recommend to girls under 21 to see a gynecologist - but they no longer need to get pap smears, according to the American College of Obstetricians and Gynecologists.
Seems to be a reasonable new guideline. After all, too many early detections of potential signs of cervical cancer can lead to unnecessary treatments and procedures, and sometimes regrettable stress and anxiety. It's a similar argument made about mammograms, in that encouraging women to get tested a little bit later on cuts back on the risk of treating people who won't get cancer.
But many are arguing that these revised Pap guidelines do something detrimental for teenage girls: it limits their early access to sexual health education, putting them at a higher risk for STDs, and unintended pregnancies. Harold Wiesenfeld, M.D. tells Denise Mann at CNN, "If women hear that they no longer need Pap tests annually or until they are 21, perhaps they wouldn't seek any preventive health care, and whether this results in decreased screening and identification of chlamydia and other STDs remains to be determined, but it is concerning."
Which raises the question, is it worth the risk?
The guidelines are coming up at a time when a growing number of teenage girls need more and more awareness about sexual health and taking care of their bodies. If there is any chance at all that less women will have access to preventive health care, then perhaps the guidelines have an indirect consequence that should be considered more.
Still, the overall point of the new Pap guidelines is to ensure that people are being accurately diagnosed with cervical cancer, and that overdiagnosis and better treatment can be provided for all women. Sexual health education needs to be provided in more than one outlet, and it's not right for institutions to depend on papsmear tests as the only resource for young women to learn about sexual health and preventive care. A better healthcare system, stronger and accurate sexual health education, and an overall community commitment to taking care of teenage girls and their health, will be what ensures that our STD statistics don't keep rising.
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Our medical system tends to err on the side of too much intervention. The guideline for medicine should be: first, do no harm.
If a procedure is not medically necessary, and it causes stress, worry, anxiety through overdiagnosis, then it is doing harm, because stress and anxiety are well-documented to have negative impacts on health.
It sounds like the people arguing that these young women should be getting pap smears are only using the argument that "it gets them in the door" of the gynecologist's office. It is precisely this mentality that has caused the problems in our medical system (too much intervention, rising healthcare costs, unnecessary treatments).
Sexual Health Education can and does happen in schools and STD testing happens at free clinics and on college campuses. If the goal is quality sex education and free and easy access to anonymous STD testing, then the medical community needs to focus on those things. Advocating to keep an unnecessary procedure in place just because of tangentially-associated benefits is misguided.
December 2, 2009 - 3:36pmThis Comment