Women Wary of Less Frequent Pap Smears
New Recommendations Call for Cervical Cancer Screening Every 3 Years
Nov. 25, 2003 -- Despite new recommendations that call for less
frequent cervical cancer screening among low-risk women, new research shows
many women are reluctant to give up their annual Pap smears.
Several health organizations, including the U.S. Preventive
Services Task Force, the American Cancer Society, and the American College of
Obstetricians and Gynecologists, now recommend that women at low-risk for
cervical cancer only need Pap smears every two to three years after three
consecutive normal Pap smear results.
In the past, annual Pap smears were recommended for these women
for cervical cancer screening. But recent studies have shown little evidence
that women who receive annual testing are at significantly lower risk for
invasive cervical cancer than women who are tested every three to five
Women Question New Pap Smear Recommendations
In the study, researchers asked a group of 673 women from a
health maintenance organization how they felt about the new guidelines in a
series of focus groups, and women expressed strong opposition to reducing the
frequency of the tests.
"Most of the women we interviewed were firmly set against
reducing the frequency of Pap tests," says researcher Mindy Smith, MD, MS,
of the department of family practice at Michigan State University, in a news
Among the reasons cited for believing yearly Pap smears are
preferable was the belief that Pap tests are successful in reducing cervical
cancer deaths and that some Pap tests are inaccurate and therefore need to be
Researchers say the women were also distrustful of the
rationale for the suggested changes. Many of them said they were suspicious
that reducing frequency of testing is motivated by concerns over cost rather
than quality of care.
In addition, the study also showed that more than half of the
women did not know that the recommendations for cervical cancer screening had
changed. Of these women, 20% were skeptical and 50% made negative comments
about the changes.
"Women need reasurrance," says Smith. "The habit of
having an annual visit to a clinician for a Pap smear appears to be firmly
entrenched and viewed as an integral part of a woman's health care. It is a
habit that has been socialized over many years and will likely be difficult to
The results appear in the November/December issue of the
Annals of Family Medicine.
"We hope that the findings from our study will help
enlighten the current debate over the frequency and timing of Pap tests based
upon risk of cervical cancer," says Smith. "As this study makes clear,
health-care providers face significant barriers to putting risk-based screening
recommendations into practice."