Women older than 30 should be screened for human papillomavirus every five years with a Pap test to detect cervical cancer though the results may lead to “significant” harm, a U.S. advisory panel said.
The findings of the U.S. Preventive Services Task Force update a 2003 recommendation that encouraged cervical cancer screening in sexually active women. A draft report the panel issued in October concluded “more complete evidence is needed” before HPV screening is widely adopted for the age group.
“Screening should fit the ideal of doing no harm, yet providing substantial benefit,” according to an editorial accompanying the guidelines, published yesterday in the Annals of Internal Medicine. “False positive test results can lead to over diagnosis, misdiagnosis and the potential for unnecessary diagnostic testing, procedures, treatments and their inherent risks.”
The findings largely agree with the recommendations of three cancer groups also issued yesterday that discourage screening in women younger than 21 and older than 65. The task force and cancer groups recommend Pap tests alone every three years for women 21 to 30 years old.
“Pap tests have been done yearly in the past, but we now know that annual screening is not needed and in fact can lead to harm from treatment of cell changes that would never go on to cause cancer,” said Debbie Saslow, director of breast and gynecologic cancer for the American Cancer Society, in a statement.
About 12,700 new cases of cervical cancer will be diagnosed in the U.S. this year, resulting in 4,290 deaths, according to the National Cancer Institute. Most cases of cervical cancer are caused by papillomavirus, a sexually transmitted infection. From 2004 to 2008, the median age for a positive diagnosis was 48, according to the cancer institute.
The panel last October issued a report that prostate-cancer screening doesn’t save enough lives to justify exposing men to the risks of death, incontinence and impotence. The group also drew criticism during debate over the U.S. health-care overhaul when it recommended in 2009 that women should start regular breast cancer screening at age 50, not 40.
The task force is a government supported group of doctors formed in 1984 to provide advice on screening, counseling and preventive medicines based on an impartial assessment of scientific evidence. Recommendations may prompt insurers to change their coverage guidelines.
The American Cancer Society, American Society for Colposcopy and Cervical Pathology and American Society for Clinical Pathology jointly issued their recommendations yesterday on HPV screening and Pap tests.