THE FOLLOWING IS AN INTERVIEW WITH NANCY VAN VESSEM, M.D., THE CHIEF MEDICAL OFFICER AT CAPITAL HEALTH PLAN.
ANGELA: Why are the recommendations for cervical cancer screening changing ?
DR. VAN VESSEM: Research has shown that Human Papilloma Virus (HPV), a sexually transmitted virus, is the primary cause of cervical cancer. That means that not all women have the same risk. Scientists also have more information about the natural course of HPV infection and how it can lead to cervical cancer but also research has shown that for many women, the body’s immune system is successful in stopping the virus.
ANGELA: How is this information leading to changes in the guidelines?
DR. VAN VESSEM: The primary recommendation that is not changing is that most women should have cervical cancer screening. One of the changes under consideration is that women who have not had sexual intercourse do not need cervical cancer screening. Also The USPSTF is recommending against screening for cervical cancer in women younger than age 21 years, regardless of sexual history. Women 65 years of age and older who have had adequate screening do not need to continue screening.
The current guidelines are that if a woman does not have a history of an abnormal Pap test, then she can wait 2-3 years to be rescreened. On the other hand, if a women has a history of an abnormal Pap test or a history of HPV, she may require more than one Pap test each year. The screening guidelines are for low-risk asymptomatic women not high risk women.
ANGELA: Is there a recommendation regarding testing for HPV?
DR. VAN VESSEM: The recommendation is if the cervical cancer screen shows some abnormality in the cells then proceeding to testing for HPV is an efficient strategy. Scientific evidence does not support HPV testing on a routine basis.
ANGELA: What is the “take home” message for the individual women?
DR. VAN VESSEM: The individual women should talk with her physician or other healthcare provider about her personal risk for cervical cancer which would determine Pap testing intervals. It’s also important to recognize that an annual visit has many other components so even if someone doesn’t need an annual Pap test, there is other testing that may be recommended and done during a routine visit.
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