Published November 20, 2014
Once again women's health experts are changing their minds, and it's leaving many women confused and frustrated. This time, the American College of Obstetricians and Gynecologists (ACOG) says Pap smears for women under the age of 21 are doing more harm than good.
The standard of care has always been for women to get annual cervical cancer screenings after becoming sexually active or by age 21. A pap smear can be used to diagnose human papillomavirus (HPV) and other pelvic infections, which may lead to cervical cancer and infertility. In all honesty, cervical cancer in women under 21 is quite rare, so the fact that the ACOG is now saying these tests are unnecessary in adolescents may have some truth to it. That's unless, the patient has a compromised immune system or a history of sexually transmitted infections.
Cervical cancer forms in the tissues of the cervix, which connects the uterus and the vagina. This is a slow-growing cancer, which might not have any symptoms. The only real way to find it is through regular Pap tests. These new guidelines add to the recommendations issued in November 2009. Those stated that women between 21 and 30 years old should get cervical screenings every two years instead of annually.
In the past 30 years, cervical cancer rates in the U.S. have fallen by more than half. That's thanks, in large part, to cervical cancer screenings. So you could argue, "Why would the ACOG recommend against it for young women?"
Let's look at the big picture. The National Cancer Institute estimates that 4,210 women will die from cervical cancer this year. And from 2003-2007 approximately 0.2 percent were diagnosed under the age of 20. That's a minute number and therefore unless an adolescent has a weakened immune system because of HIV infections, organ transplants or long-term steroid use, she should only get tested after age 21. Otherwise we are just wasting our resources and putting young women through unnecessary testing.