Dr. Sunil Gandhi, Cancer & Blood Disease, 01/15/13

Cervical cancer is an extremely preventable cancer. It is caused by infection by a virus called HPV, or Human Papilloma Virus.

This virus is most commonly passed from person to person during sexual activity. There are different types, or strains, of HPV, and some strains are more strongly associated with certain types of cancers. HPV vaccines protect against certain strains of the virus.

With more advanced understanding of this virus and its role in causing cervical cancer, recent guidelines for screening of cervical cancer are revised. Until now, a pap test was the only available test for screening for cervical cancer.

Now a new test called HPV DNA testing is also available.

“Pap tests have been done yearly in the past, but we now know that annual screening is not needed and can lead to harm from treatment of cell changes that would never go on to cause cancer,” according to Dr. Debbie Saslow, director of breast and gynecologic cancer for the American Cancer Society.

New guidelines recommend for screening to start at age 21, regardless of when a woman becomes sexually active. The groups concluded most HPV infections, which are spread through sexual contact, and cervical changes that are detected before this age would likely resolve on their own and not become cancerous.

The recommendations also extend the time interval between tests. Women ages 21 to 65 should be screened with the pap test every three years. Women ages 30 to 65 who have the HPV DNA test and the pap test (co-testing) can be screened every five years.

When not to screen

Women who have had a hysterectomy and no longer have a cervix should not be screened, according to the new guidelines.

Likewise, women older than 65 should not be screened if they have had three consecutive negative pap tests or two consecutive negative co-tests within 10 years, and the last test was administered within five years.

However, women with a history of cervical precancer or a cancer diagnosis should continue screening as recommended by their physician, according to the new guidelines, for at least 20 years, even if it means testing after age 65.

In addition, the guidelines recommend against using the HPV DNA test alone in women of any age or using co-testing in women younger than 30 years of age, because HPV is common in young women, but the vast majority of HPV infections are transient.

This new set of guidelines will reduce the number of pap smears. This also avoids unnecessary further testing if a pap test is questionable.

Dr. Sunil Gandhi is a hematologist and oncologist. He is volunteer medical adviser of the Citrus Unit of American Cancer Society. Write to 521 N. Lecanto Highway, Lecanto, FL 34461, email sgandhi@tampabay.rr.com or call 352-746-0707.