Pamela A. MacLean
Newswire21.org

Officials said Friday it was pure coincidence that two unrelated medical groups advised women to cut back on tests of breast and cervical cancer.

The American College of Obstetricians and Gynecologists advised 20-something women can have a Pap smear test every two years instead of annually. Older women can wait three years to catch slow-growing cervical cancer. No tests are needed before the age of 21, the association said in an article published in the journal Obstetrics & Gynecology.

The guidance came two days after a report by a government advisory panel, which recommended women wait until age 50 to begin routine mammograms, rather than 40, and scale back from annually to every two yours.

The advice on cervical exams stirred up controversy that ranged from women on the Internet to members of Congress.

"I personally think that is crazy," wrote a poster who called herself  StayAtHomePrincess.   "So say you get HPV at 15, but don't get a pap until your are 21..."

Another poster on MammaHunter said, "Speaking for myself, I don't like it one bit and I don't care if I have to end up paying out of my own pocket for my exams, I'm getting a pap smear EVERY year."

Sen. Tom Coburn (R-Okla) tried to tie the two new guidelines to Democratic proposals to reform the health care system. "These are going to be set in stone," he told The New York Times. 

Rep. Rosa DeLauro (D-Conn.) denied there was any connection between the two reports and the debate over the health care bill. "Republicans are using these new recommendations as a distraction," she told the paper.

Health and Human Services Secretary Kathleen Sebelius previously distanced the Obama administration from the mammogram standards, which were proposed by a government medical advisory panel. "They do not set federal policy and they don't determine what services are covered by the federal government," she said.

Prior Standard
Previously, ACOG had urged a first Pap either within three years of first sexual intercourse or at age 21.

"The tradition of doing a Pap test every year has not been supported by recent scientific evidence," said Dr. Alan Waxman, the University of New Mexico in Albuquerque specialist who helped develop the guidelines. "A review of the evidence to date shows that screening at less frequent intervals prevents cervical cancer just as well, has decreased costs, and avoids unnecessary interventions that could be harmful."

The ACOG report said women over 29 should wait three years between Paps once they have had three consecutive clear tests.  Other national guidelines have long recommended the three-year interval; ACOG had previously backed a two- to three-year wait.

Women with HIV, other immune-weakening conditions or previous cervical abnormalities may need more frequent screening.

Paps can spot pre-cancerous changes in the cervix in time to prevent invasive cancer, and widespread use has halved cervical cancer rates in the US in recent decades.  About 11,270 new cases will be diagnosed this year, and about 4,070 women will die from it, according to the American Cancer Society.  Half the women diagnosed with cervical cancer have never had a Pap, and another 10 percent haven't had one in five years.

Cervical cancer is caused by certain strains of the extremely common sexually transmitted virus called HPV, for human papillomavirus.  There is a new HPV vaccine that should cut cervical cancer in the future; ACOG's guidelines say for now vaccinated women should follow the same Pap guidelines as unvaccinated women.