Last week, the U.S. Preventive Services Task Force released its latest recommendations regarding cervical screening guidelines. The public has until November 15, 2011 to make comments at which time the organization will then compile all results and determine the final outcomes. The American Cancer Society (ACS) is expected to make their recommendations regarding this information some time next year.
Comments can be made at:
The recommendations and rationale include several changes of which women should be aware. One thing which strikes me is the fact that they admit they have no information available to determine how to incorporate known risk factors into these guidelines! One must ask, with all the research being conducted -- why not?
As a registered nurse, I always considered a patient's risk factors for any disease with respect to that patient's follow-up and treatment, yet is not happening here. I disagree with the exclusion of testing of all women under 21 years of age.
This blatantly disregards two of the known risk factors which can affect persistent disease -- early sexual onset and multiple partners. Yet in the 2006 guidelines, this same organization stated: "Indirect evidence suggests most of the benefit can be obtained by beginning screening within 3 years of onset of sexual activity or age 21 (whichever comes first) ..." and, "The USPSTF concludes that the benefits of screening substantially outweigh potential harms."
If this were a static situation and people never changed relationships perhaps these proposals would be more plausible but this simply isn't the case. By way of example, if a woman changed relationships a month after receiving her Pap, she may then be dealing with a high risk strain of HPV for three years before being tested again.
I have spoken to too many women, even those in monogamous relationships, whose HPV has advanced at a far faster pace than this.