Doctors screen for cervical cancer too often

Researchers based at the Centers for Disease Control and Prevention (CDC) found that many primary care doctors would bring women back for cancer screening annually -- while recommendations generally call for a three-year wait after normal tests.That means more costs to women and the healthcare system, as well as a risk of unnecessary treatment for false-positive test results -- with very little additional cancer-catching benefit.Theres really no advantage to annual screening compared to screening every two or three years, lead author Katherine Roland told Reuters Health.Guidelines from the American Cancer Society and other organizations recommend that women age 30 and older are screened using Pap smears and tests for the human papillomavirus, or HPV. (For younger women, the ACS recommends starting testing at age 21 or three years after beginning sexual activity.If both tests are normal, those guidelines call for a three-year wait before the next screening. Thats because HPV -- which causes changes in the cervix that can lead to cancer -- may take a decade to progress to that point.No test is perfect, said Philip Castle, an HPV expert at the American Society for Clinical Pathology in Chicago. But, he added, a single negative HPV test is very good at ruling out disease.Even when doctors use just a Pap test, Roland said, a woman who has had a few normal tests in a row can go two or three years before her next screening.For the current study, she and her colleagues sent out questionnaires to a representative sample of about 600 office-based doctors and hospital departments around the country. They asked doctors and staff what tests they used for cervical cancer screening and presented them with three patient scenarios.In those scenarios, a woman age 30 to 60 has had two consecutive normal Pap tests but no HPV tests; two normal Paps and a negative HPV test; or a negative HPV test but no recent Pap tests.In all of those cases, guidelines recommend waiting three years before screening the patient again, the authors explain in the American Journal of Obstetrics & Gynecology. But for each scenario, between 67 percent and 85 percent of doctors said they would bring the woman back in a year.