For nearly three generations, women have been taught that annual Pap smears and mammograms were essential to good health said the New York Times. Now that’s changing. National guidelines urge less frequent screening for breast and cervical cancer.
The U.S. Preventive Services Task Force (USPSTF), a group of primary care providers, authored some of the new guidelines. The new guidelines recommend most women start regular breast cancer screening at age 50, not 40.
Mammograms should then be done every two years. Women, 65 and older should get screened every two years through age 74. There’s insufficient evidence mammogram screening is effective for women age 75 and older.
These recommendations don’t apply to women with unusual risk factors for breast cancer.
One of the main reasons behind the new guidelines is to reduce harm from overtreatment.
Mayo Clinic said according to the USPSTF, women who have mammograms die of breast cancer less frequently than women who don't. However, the USPSTF said the benefits of mammograms don't outweigh the harms for women ages 40 to 49.
Potential harms may include false-positive results that lead to unneeded breast biopsies and accompanying anxiety and distress.
The New York Times wrote the harms are nearly cut in half when women have mammograms every other year instead of every year. But the benefits are almost unchanged.
Similar guideline changes have been made in recent years for cervical cancer screenings. No longer are annual Pap smears necessary.
Both the USPSTF and the American College of Obstetricians and Gynecologists (ACOG) say women should wait longer to begin cervical cancer screenings and be screened less frequently.
All women should start screening at age 21 and have a Pap smear every three years. For women 30 and over, Pap tests should be done every three years. The guidelines also recommend against screening women over 65 who have had adequate prior screening and are not otherwise at high risk for cervical cancer.
The New York Times wrote these recommendations don’t apply to women with unusual symptoms, unusual Pap test results or histories of dysplasia, cervical cancer or other illnesses.
While many women don’t think screening tests can be harmful, reported the New York Times, medical experts say the risks are real. A test can trigger unnecessary further tests, like biopsies, that can create extreme anxiety. And mammograms can find cancers that grow so slowly they’d never be noticed in a woman’s lifetime, resulting in unnecessary treatment.
ACOG said other harms may include potential stigmatization from a sexually transmitted infection diagnosis; discomfort from additional diagnostic and treatment procedures; bleeding from treatment; and, longer term, an increased risk of pregnancy complications such as preterm delivery in women previously treated with excisional procedures.
WomensHealth.gov advised the new guidelines are just that -- guidelines. Health care providers and women should work together to personalize individual screenings.
Sources:
Parker-Pope, Tara. "The Annual Doctor Visit Loses Some Relevance - NYTimes.com." Health and Wellness - Well Blog - NYTimes.com. N.p., n.d. Web. 21 Mar. 2012.
http://well.blogs.nytimes.com/2012/03/19/the-annual-appointment-loses-some-relevance/?nl=health&emc=edit_hh_20120320
Kolata, Gina. "In Reversal, Panel Urges Mammograms at 50, Not 40 - NYTimes.com." NY Times Advertisement. N.p., n.d. Web. 25 Mar. 2012. http://www.nytimes.com/2009/11/17/health/17cancer.html?_r=2
ParkerPope, Tara. "New Guidelines Advise Less Frequent Pap Smears - NYTimes.com." Health and Wellness - Well Blog - NYTimes.com. N.p., n.d. Web. 25 Mar. 2012. http://well.blogs.nytimes.com/2012/03/14/new-guidelines-advise-less-frequent-pap-smears
"Screening tests for women | womenshealth.gov." womenshealth.gov . N.p., n.d. Web. 25 Mar. 2012. http://www.womenshealth.gov/screening-tests-and-vaccines/screening-tests-for-women
Rodriguez, Diana. "10 Health Screenings All Women Should Have - Women's Health Center - Everyday Health." Health Information, Resources, Tools & News Online - EverydayHealth.com. N.p., n.d. Web. 25 Mar. 2012. http://www.everydayhealth.com/womens-health/10-screenings-all-women-should-have.aspx
Pruthi, M.D., Sandhya . "Mammogram guidelines: What's changed? - MayoClinic.com." Mayo Clinic. N.p., n.d. Web. 25 Mar. 2012. http://www.mayoclinic.com/health/mammogram-guidelines/AN02052
Wysocki, Susan , and Susan Scanlan. "Unique to Women - What the New Cervical Cancer Screening Guidelines Mean for Women - Our Bodies Ourselves." Information on Women's Health & Sexuality - Our Bodies Ourselves. N.p., n.d. Web. 25 Mar. 2012. http://www.ourbodiesourselves.org/book/companion.asp?id=28&compID=138
Duggan, Eliza. "Our Bodies Our Blog." Our Bodies Our Blog. N.p., n.d. Web. 25 Mar. 2012. http://www.ourbodiesourblog.org
Barclay, Laurie. "Medscape: Medscape Access." Medscape: Medscape Access. N.p., n.d. Web. 25 Mar. 2012. http://www.medscape.com/viewarticle/739356
"ACOG - New Cervical Cancer Screening Recommendations from the U.S. Preventive Services Task Force and the American Cancer Society/American Society for Colposcopy and Cervical Pathology/American Society for Clinical Pathology."ACOG - American Congress of Obstetricians and Gynecologists. N.p., n.d. Web. 25 Mar. 2012. http://www.acog.org/About_ACOG/Announcements/New_Cervical_Cancer_Screening_Recommendations
"Screening for Cervical Cancer." U.S. Preventive Services Task Force. N.p., n.d. Web. 25 Mar. 2012. http://www.uspreventiveservicestaskforce.org/uspstf11/cervcancer/cervcancerrs.htm
Brawley, Otis. "No more annual Pap smear: New cervical cancer screening guidelines - CNN.com." CNN.com - Breaking News, U.S., World, Weather, Entertainment & Video News. N.p., n.d. Web. 27 Mar. 2012. http://www.cnn.com/2012/03/14/health/brawley-cervical-cancer-screenings/index.html
Reviewed March 27, 2012
by Michele Blacksberg RN
Edited by Jody Smith