If you’re a woman over the age of 21 then chances are you know all too well the uncomfortable process of probing and prodding that is getting a cervical cancer screening test, known as a Pap smear. Now, new guidelines present an alternative method of screening, and it could make Pap smears obsolete for women over 30.
Evidence-based recommendations published by the US Preventive Services Task Force (USPSTF) in the latest issue of the Journal of the American Medical Association suggest women can be screened for cervical cancer by testing for “high risk” strains of human papillomavirus (HPV) every five years if they feel comfortable with it. That means there is no need to have simultaneous pap tests. That’s because nearly all cervical cancer cases are caused by HPV, so testing for the virus before it leads to cancer makes for a great alternative. For women ages 21 to 29, the UPSTF says a Pap smear is still the most effective way to detect cervical cancer, but recommendations change testing to every three years instead of annually.
The new guidelines suggest:
- Women ages 30 to 65 can get the HPV test every five years or a Pap smear every three, or a combination every five years.
- Women over 65 who have had clear tests likely don’t need more testing.
- Women under 21 don’t need testing.
The new recommendations come after a study early this year found testing for cancer-related HPV outperformed the effectiveness of Pap smears in women over the age of 30.
Cervical cancer used to be the leading cause of cancer-related death in American women before early detection methods were normalized several decades ago. Previous guidelines established in 2012 suggested women aged 30 to 65 undergo co-testing with both the HPV test and Pap smear every five years. While co-testing is still preferable, the new standards mean women can avoid harm caused by having too frequent screenings, such as unnecessary biopsies and follow-up appointments.
"Our work demonstrated that there is now strong evidence for the effectiveness of high-risk HPV testing used alone as a cervical cancer screening test," said study author Joy Melnikow in a statement. "We also found that both HPV screening strategies had higher false-positive and colposcopy rates than Pap smears. These false positives could lead to more treatments with potential harms."
An estimated 79 million Americans, most in their late teens and early 20s, are infected with HPV through sexual contact. Most of the time the virus resolves itself naturally but can sometimes lead to cervical cancer.
Pap smears test for precancerous cells and cancer around and in the cervix, so it’s still not a replacement for other screenings, such as sexually transmitted diseases or infections.