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Home Screening and Treatment Testing and Treatment Revised Cervical Cancer Screening Guidelines Say Delay Paps Until Age 21

Revised Cervical Cancer Screening Guidelines Say Delay Paps Until Age 21

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Citing the low prevalence of the cervical cancer in young women, updated guidelines released by the American College of Obstetricians and Gynecologists (ACOG) recommend that cervical cancer screening begin no earlier than age 21.

ACOG guidelines previously called for cervical cancer screening with Pap tests to start either at age 21 or within three years of first intercourse. Young women often have their first Pap test at the time of their initial pelvic examination, often well before age 21. While HPV infection is common in adolescent and young women, both the virus and related cervical cell changes are most often harmless and tend to clear fairly quickly with women in this age range. Given that cervical cancer is rarely detected in women in their teens and 20s, ACOG cited concerns that screening women younger than 21 years old may lead to unnecessary and harmful evaluation and treatment that may weaken the cervix. Studies show, for example, excisional procedures done for cervical lesions are associated with an increase in premature births and Cesarean sections.

The revised guidelines also recommend that women between the ages of 21 and 29 receive cervical cytology screenings every 2 years (routine HPV testing with women under age 30 is not recommended). Evidence shows that screening women every year has little benefit over screening every other year and is cost-effective.

Women’s health advocates note that increasing the age at which cervical cytology screenings should take place does not negate the need for counseling and testing of sexually active adolescents. There remains a need for young women, parents, and health care providers to think of sexual and reproductive health issues beyond Pap smears and cervical cancer. This new recommendation is not a reason for putting other aspects of adolescents’ sexual well being on the back burner until the age 21. The Centers for Disease Control and Prevention, for example, recommend that all sexually active females under age 26 have an annual chlamydia test and all age-appropriate vaccines.

Read more on ACOG’s website.