Pap test experts say fewer follow-ups now necessary

Associated Press

CHICAGO — New Pap test guidelines issued by a panel of experts could mean fewer return visits and less anxiety for the millions of women whose cervical cancer results come back inconclusive.

Currently, many of the estimated 2.5 million American women a year with abnormal but inconclusive results are given at least two follow-up Pap tests within a year; or a colposcopy test, in which the cervix is examined and sometimes biopsied; or a test for the human papillomavirus, or HPV, the chief cause of cervical cancer.

The new guidelines say HPV testing alone should be the preferred method for many women because it is more convenient for the patient. In many cases, the HPV test can be done from the Pap test sample.

If the HPV test is negative for the riskiest forms of the virus — as is the case in about half of these women — the patient can be virtually assured she does not have cancer and does not need more follow-up testing, the experts said.

By some estimates, that could save hundreds of millions of dollars a year in health care costs.

The guidelines were created at a conference last year sponsored by the American Society for Colposcopy and Cervical Pathology.

The guidelines reflect doctors’ better understanding in recent years of HPV and how a few high-risk strains of the virus are the primary cause of cervical cancer.

"Right now, there’s a lot of overdiagnosis, a lot of extra unneeded follow-up tests that are being done, which are a tremendous health care cost but also a tremendous cost to the women in terms of anxiety, time and discomfort," said the cancer society’s Debbie Saslow. If many women with inconclusive results can be reassured, "that will be a big benefit for society."

Pap tests plus an office visit may cost about $40, compared with about $100 for an HPV test, Saslow said, while colposcopy can cost $300 or more.