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New guidelines calling for most women to receive Pap tests less often are based on sound science and should be followed, local doctors say.

Healthy women can wait until age 21 to get a first Pap smear and then be screened every other year until age 30, the American Congress of Obstetricians and Gynecologists recommended recently.

After age 30, women who have had normal results and who have tested negative for human papillomavirus can be screened with a Pap test every three years, ACOG said.

Previous recommendations called for annual screening for all women beginning three years after the onset of sexual activity or at age 21, whichever came first.

“Every year is probably overkill,” said Dr. Linda Johnson, a gynecologist at Billings Clinic.

Extensive research into human papillomavirus, or HPV, the cause of 99.7 percent of cervical cancers, led to the change in guidelines. HPV is transmitted during sexual contact.

“We understand the life cycle of the virus,” said Dr. John Joyce, a gynecologist at Billings Ob-Gyn Associates, an affiliate of St. Vincent Healthcare. “We know now that the body will overcome the virus if we give it time.”

Pap tests look for evidence of HPV infection on a woman’s cervix. If infection is detected, doctors can take a number of steps to address it, including biopsies and surgery.

But those steps can have long-term consequences, including pre-term labor, and may not be necessary. Most young women’s bodies will clear the virus within a couple of years of contracting it.

“Are we really stopping cervical cancer or are we just doing more things to young girls?” Johnson asked.

A test every couple of years will detect HPV infections that are persistent and could lead to cancer, Johnson said.

Slightly more than 11,000 cases of cervical cancer are diagnosed among American women each year. Most of them are found in women who have never had a Pap test or who have not had one in many years.

The test is still the best way to detect cancer and has been credited with reducing the incidence of cervical cancer by more than 50 percent over the past 30 years. It is so successful because it can identify cells that will turn into cancer, allowing the disease to be treated before it really takes hold in a woman’s body.

The new guidelines do not mean that women should see their doctors less frequently. It is still important to receive a pelvic exam every year.

And there are exceptions. Women who smoke probably should be screened more often, because smoking dramatically increases the risk of cervical cancer, and women who have had abnormal Pap test results should also be screened more frequently.

Young women and men should also consider receiving the HPV vaccine, Johnson said. It protects against the four strains of HPV that cause the vast majority of cervical cancers and genital warts.

The vaccine has been approved for men and women through age 26 and is recommended at age 11 — before sexual activity has begun.

Contact Diane Cochran at or 657-1287.

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