By Theresa Boyle
Women should start getting regular Pap tests at age 25 rather than 21, according to a national advisory panel.
While women should continue to be screened for cervical cancer every three years, the testing should start at a later age because of potential problems from the procedure, state newly released guidelines from the Canadian Task Force on Preventative Health Care.
“What we are doing is balancing the benefits of screening and reducing cancer against the potential harms that come from screening,” explained Dr. James Dickinson, chair of the task force.
The new guidelines were published online Monday in the Canadian Medical Association Journal.
The task force, created by the Public Health Agency of Canada, advises primary care providers, including family doctors, on preventative health care.
Cancer Care Ontario, the provincial body that co-ordinates cancer services, has recommended sexually active women start having pap smears at age 21. The agency is expected to revisit that advice in light of the new guidelines from the task force.
Potential harms from screening include false positives, anxiety and unnecessary treatments. Those treatments can involve biopsies and even removal of part of the cervix. That in turn can result in scarring of the cervix and greater risk of miscarriage and premature labour.
“There is a lot of disturbance involved in having an abnormal Pap smear. There is a lot of worry. People don’t sleep well after they have been told they have an abnormal Pap smear,” Dickinson explained.
The guidelines also recommend screening end for women aged 70 and over who have had three successive negative Pap test results in the previous 10 years.
Screening guidelines should be appropriate for the risk profiles of women. For example, women with compromised immune systems may need more frequent screening while those who have had complete hysterectomies for benign issues will not need further screening.
“Practitioners should be aware of women’s values, preferences and beliefs about screening and discuss these in the context of the potential benefits and harms of the screening process,” the authors write.
In 2011, an estimated 1,300 new cases of cervical cancer were diagnosed in Canada, and about 350 women died of it.
- Torstar News Service