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Pap smears, mammograms and new health guidelines: A “perfect storm” for women

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It was a busy, confusing week last week for women’s health news. And for the time being, women and their doctors are left to figure out the new mammogram and Pap smear recommendations for themselves. Here's what you need to know:

Friday, the American College of Obstetricians and Gynecologists issued new guidelines on Pap tests, recommending that women begin the tests at age 21 (instead of 18) and that they have tests every other year in their 20s and every three years in their 30s (instead of annually). Questions of whether women in the United States are being over-screened and over-treated are at the heart of the issue.

The announcement came just a few days after the U.S. Preventive Services Task Force published new recommendations for mammograms – that women not be screened at all until age 50, and then only every two years. Tempestuous days ensued, in which patients, doctors, hospitals and cancer umbrella organizations balked and vowed to follow the old guidelines, which call for annual mammograms after age 40.

Women who had gotten breast cancer in their 40s – or even their 30s – and survived due to early detection told their stories as often as they could, hoping to blunt the effect of the new guidelines. Health and Human Services Secretary Kathleen Sebelius said the government would ignore the new recommendations, at least for now. And women who had found their own cancers through breast self-exams felt betrayed when the task force said that emphasis on self-exams wasn’t worth the trouble.

The timing of the cervical cancer screening story was accidental. But it couldn’t have been worse. Not only did the two announcements come back to back, they also came while the Senate was working through its version of the health care reform bill. The questions came quickly: Is this the wave of the future: Less care, perhaps leading to less insurance coverage as well?

"There's no link between us and the [task force] recommendations," Greg Phillips, a spokesman for the ob/gyn group, told CNN. "And it's a different animal. Cervical cancer is very slow-growing versus some breast cancers."

At what age should women start receiving mammograms?
Younger than 40
48% (63 votes)
40 to 49
39% (51 votes)
50 and older
14% (18 votes)
Total: 132 Votes

Add a Comment3 Comments

EmpowHER Guest

The government should not have a say in my health and my body... isn't that what women say? This is the same thing! Whether or not I need a pap smear or a mammogram is a decision between my doctor and myself.....

My daughter, a 16 year old, was raped... she was refused a pap smear. The doctor said, "You can thank your government for that"

With the taking away of the pap smear, Doctors are not doing pelvic exams... how will they diagnose trichinosis or vaginosis, or anything else? That is what has happened... it is not JUST about cervical cancer, it is absolutely about health care rationing and the rights of women to have proper, preventative healthcare.

October 17, 2012 - 5:45pm
Expert HERWriter Guide Blogger

Hi Diane - There's an old saying about when life hands you lemons you should turn it into lemonade. We need to stop and take a longer look at the net impact of the multiple and confusing statements about women's health screenings. I think the long term impact will be a lot more positive than it seems right now.

While healthcare professionals have discussed and debated these types of guidelines for years, the general public has typically not been part of the dialogue. I'm sure many women have learned more in the last couple of weeks about the pros and cons of screenings than ever before, and that more dialogues than ever are occurring between women and their physicians about personal needs and personal guidelines. That's healthy, and something that's been needed for a long, long time.

The organizations that announced these guidelines seem to have come from the "old" days when health "rules" were made, and women were just expected to follow them without question. The public uproar has been a good way of letting those in the bubble of the professional healthcare environment know that the patient has become a healthcare consumer, with full access to the Internet and incredible information, as well as someone who will no longer just blindly accept "rules" simply because some group of experts came up with them.
I don't like the lemons that were thrown at us last week and the way we had to keep them from hitting us. I do look forward to the future when this settles and we have our various flavors of individual lemonade to chose from for the sake of our own best health.
Thanks for writing about this,

November 23, 2009 - 5:41pm

I wanted to add a link to ABC News' story on this, because it does an excellent job of outlining some of the problems associated with too many pap smears, including how unneeded HPV (human papillomavirus) treatment can affect future pregnancies:


November 23, 2009 - 10:07am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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