Doctors Screen For Cervical Cancer Is Too Often
Most doctors decide for testing women for cervical most cancers more frequently than the guidelines suggest, based on a new study.
Researchers based at the Center for Disease Control and Prevention (CDC) found that many main treatment physicians brings her to cancer testing each year — as the suggestions usually demand waiting around three years following a regular check.
That means more price to women and wellness systems, as well as the risk of unnecessary strategy to false-positive test outcomes – with hardly any extra benefit cancer-catching.
“There’s really no benefit for annual screening compared with screening every two or three years,” says author Katherine Roland Reuters Health.
Guidelines from the American Cancer Society and other organizations recommend that women age 30 and older who were screened using the Pap smear and testing for human papillomavirus, or HPV. (For younger women, the ACS recommends testing begins at age 21 or three years after starting sexual activity.)
If both tests normal, the guidelines call for waiting three years before the next playback. That’s because HPV – which causes changes in the cervix that can cause cancer – it may require decades to progress to that point.
“The test is not perfect,” said Philip Castle, an HPV expert at the American Society for Clinical Pathology in Chicago. But, he adds, “a single negative HPV test is a very well rule out the disease.”
Even when doctors simply use the Pap test, Roland said, a woman who has had several consecutive normal tests can go two or three years before the next screening.
For the current study, he and his colleagues sent questionnaires to a representative sample of about 600 office-based physicians and hospital departments across the country. They asked the doctors and staff what they are tests used to screen for cervical cancer and the patient presented with three scenarios.
In this scenario, women ages 30 to 60 with normal Pap tests currently has two previous tests consecutive normal smears, but there is no HPV test, two normal Pap and negative HPV test, or a negative HPV test but no other new Pap test.
In all cases, the guidelines recommend waiting three years before screening more patients, the authors explain in the American Journal of Obstetrics & Gynecology. But for each scenario, between 67 percent and 85 percent of doctors said they would bring her back in a year.
And additional tests are not dangerous.
Roland appoints an additional fee may be worn by women to obtain child care and make it to the doctor’s office – plus the cost to the health system strained ordering more tests.
And any additional inspection increases the likelihood of getting a “false positive” results on the test – a test that means finding something that does not turn into cancer. In this case, women will need more invasive tests to rule out the disease, says Roland, and the risk of “undue danger” of the procedure.
“Some of it is, do not go looking for before you need to go looking for you’ll find stuff you’d rather not find,” said Puri, who was not involved in the new study.
Results from a survey of the same doctors have shown that many also give the HPV test with Pap smears for women under 30 – are not recommended, because HPV is common in young women and frequently go alone (see Reuters Health story on July 4, 2011).
Castle said there may be several reasons that clinicians choose to screen women more frequently than is recommended. First, they may not know about the guidelines. But women can also be used for annual testing and ask yourself.
In addition, Roland added that some doctors may be afraid of missing cervical cancer very early and get sued if they screen less frequently.
But if doctors and hospitals want to control spending and limit the unnecessary risk, attitudes have changed, researchers added.
“We need to shift toward health as opposed to the visit,” You come here every year for a Pap, ‘”said Puri.
Women should talk with their doctor about screening, especially if they think that they are being screened too often, the researchers added.
“A woman should know what tests are used,” said Dr. Mona Saraiya, co-author of the new study. “Often the only provider to do the HPV test” without informing the patient. “A woman shall say, ‘What screening tests do you do to me?”
And if doctors want women to go back again next year, women should ask them why, Saraiya said.