With a new test for human papillomavirus (HPV) recently approved for use,
the American Congress of Obstetricians and Gynecologists has revised its
guidelines for cervical cancer screening to incorporate that test as well
as the traditional Pap test.
"Some types of HPV have been found to be a precursor to certain kinds
of cancer, including cervical," says
Yen Tran, DO, an obstetrician/gynecologist at
St. Joseph Heritage Medical Group.
The revised guidelines for routine screening state that women should begin
having Pap tests to screen for cervical cancer at age 21, and have the
test done every three years until age 29. Women ages 30 to 65 can be screened
with the HPV and Pap tests simultaneously once every five years, or have
just a Pap test every three years. Women older than 65 with a recent history
of negative Pap tests and a clean cervical bill of health can stop screening
altogether. Both the Pap test and the HPV test involve the removal of
some cervical cells to be analyzed for abnormalities in a lab.
The HPV test was approved for use by the U.S. Food and Drug Administration
in July 2015. While the FDA approval says the test can be used for women
25 and older, the American Congress of Obstetricians and Physicians recommends
that the test be used on women starting at age 30.
"It's more common for young women to contract HPV, but often there
are no symptoms and the body can fight off the infection--that's why
younger women are generally advised against HPV testing," Dr. Tran
says. "But if a woman in her 30s or 40s tests positive for HPV, when
it's not as common to contract a virus, that can mean she's had
a persistent, long-term infection that never cleared up. Because it takes
several years for HPV to cause cell abnormalities, it can be a sign of
possible cervical health issues, such as cancer. This is an interim recommendation;
the landscape for cervical cancer screening can continue to change the
more physicians use this HPV test. It can also change as more women get
the HPV vaccine, which guards against certain types of high-risk strains."
If there is a history of abnormal screening results, cervical cancer or
HIV, or a weak immune system, a patient may be prescribed more frequent
screenings than stated in the guidelines. "If you have any questions
about cervical cancer screenings, talk with your healthcare provider,"
Dr. Tran continues. "Even though the recommendations don't call
for annual cervical cancer screenings such as the Pap test, it doesn't
mean you should forego your annual well-woman visits with your doctor.
Those regular visits are still a valuable tool for preventive health care."
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