Cancer awareness blogs

Who does less frequent cancer screening benefit?

By Jaime
June 15, 2010

I recently read this article from the Los Angeles Times which discusses how physicians are providing Pap smears more often than the newly recommended guidelines of every three years for women with no history of cervical cancer or past cervical health issues. Doctors are also screening more frequently for HPV. This guideline recommendation has come on the heels of the newly recommended less frequent mammogram screening, and changes in guidelines for prostate cancer screening.

Dr. George F Sawaya of UC San Francisco responded to the report saying the results were “discouraging” because frequent screening exposes women to more hazards without providing any significant benefit.

Yes, with the advent of Pap smears, the incidence of cervical cancer has dramatically decreased in industrialized countries. Cervical cancer typically grows very slowly, which is why regular Pap smears are important in detecting precancerous changes, or dysplasia. But as a woman, I would rather pay my copays or out of pocket for regular Pap smears, than be faced with cervical cancer and THOSE copays.

Yes, frequent testing is not cost-effective. But is cervical cancer and its treatment any less expensive? Physicians may be practicing defensive medicine by doing Pap tests more often, in this climate of litigious patients – but they may also be practicing from experience and gut instinct.

There are always exceptions to the rules, and doctors will always have patients whose cervical cancer grows more quickly, or whose HPV or high-grade dysplasia was missed by the lab. Have we listened to the ob/gyns who are still doing yearly Pap tests? How about the young women with cervical cancer or cervical carcinoma in situ, whose cancer or highly abnormal cells were caught after an initial negative Pap? Are we changing cancer guidelines – more often women’s cancer guidelines – in order to save money? But are we really saving money in the end? And at what cost?

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