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Study: Annual Cervical Screening May Be Harmful

10:36 AM, Jul 9, 2013   |    comments
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Despite what women have heard for decades about getting their cervical cancer screening yearly, new study suggests that could be doing more harm than good.

According to a UNC study, things changed in 2009 when accumulating scientific evidence led major guideline groups to agree on a new recommendation that women be screened less frequently: every three years rather than annually.

Despite the revised guidelines, about half of the obstetrician-gynecologists, who took a recent survey, said they continue to provide annual exams. This practice is may be more harmful than helpful, said Drs. Russell Harris and Stacey Sheridan of the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill.

"Screening is not the unqualified good that we have advertised it to be," they wrote in an editorial titled, "The Times They (May Be) A-Changin': Too Much Screening is a Health Problem." The editorial accompanied a research study reviewing physician practices around cervical-cancer screening and vaccination for human papilloma virus (HPV), which has been linked to cervical cancer.

The study, "Physicians Slow to Implement HPV Vaccination and Cervical Screening Guidelines," was published July 9 in the American Journal of Preventive Medicine.

"Screening for cervical cancer and other cancers such as breast and prostate, has clear potential for harms as well as benefits, and these must be carefully weighed before a rational decision about screening can be made," wrote Harris and Sheridan, who are professor and assistant professor of medicine, respectively, at UNC's School of Medicine. They also hold adjunct appointments at UNC's Gillings School of Global Public Health.

The study noted physicians said they were comfortable with longer testing intervals, but were concerned their patients might not come in for annual check-ups if Pap tests, the screening test for cervical cancer, were not offered. The problem, Harris said, is that annual Pap tests produce more abnormal results leading to additional, invasive testing that itself bring risks.

The newest cervical-cancer and HPV screening recommendations were released in March 2012, too recent to have been included in the July 9 study. Women should still begin Pap tests at age 21 and every three years afterward, but women between the ages of 30 and 65 may choose to extend the Pap test interval to every five years, provided they also get an HPV test, according to the U.S. Preventive Services Task Force and the American Cancer Society, among others. However, the authors added, "the debate about a do-less approach to screening-for cervical cancer and other conditions as well-is ongoing."  

*Information for this story provided by UNC News Services

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