Guidelines for cervical cancer screenings changing

VANCOUVER (NEWS 1130) – An announcement from the BC Cancer Agency is likely being welcomed by women, but it also is representative of a trend happening in public health. Guidelines for how often women should get cervical cancer screenings are changing.

In the past, doctors have told women between the ages of 21 to 69 to have a PAP test every two years. That’s being scaled back to one test every three years. Women under the age of 25 are being told they don’t need the test.

Dr. Dirk Van Neikerk, Medical Director of the Cervical Screening Program for the BC Cancer Agency, says research has found getting PAPs more often doesn’t offer much in terms of additional protection. “If you look at protection against cervical cancer of annual screening versus screening every three years, there’s really no appreciable difference. I think annual screening protects about 90 to 92 per cent whereas screening every three years the protection is 90 per cent, only about a one per cent increase in protection against an already rare disease.”

The PAP test is designed to detect cervical cell abnormalities caused by HPV. Dr. Van Neikerk says these can go away on their own. He says there will be about one case of cervical cancer for every 1000 abnormalities found.

Extra screening may also be harmful for patients. Dr. Van Neikirk says it can affect a woman’s ability to have children. “The treatment involves removing a part of the cervix and this might have an impact on reproductive health, especially increased risk for premature birth, which can be up to double the baseline risk.”

This is on top of the stress of being told you have something which could lead to cervical cancer, when it likely won’t. And then there’s the inconvenience of all these extra appointments and the costs to the healthcare system.

The Canadian Task Force on Preventive Health Care recommended this change in 2013. Similar new guidelines were adopted in Alberta last month. This same task force has also recommended getting rid of routine colonoscopies for patients at low risk for colon cancer and raising the age for regular mammograms for women from 40 to 50.

Dr. Van Neikerk says we’re learning more about how much screening we really need. “If we look for these abnormalities, we find them and then have to treat them. It’s sort of trying to balance at what point do the benefits outweigh the harms? It’s part of a bigger discussion around can too many tests be a bad thing.”

But that doesn’t mean all screening is bad for you. A PAP test every three years can reduce the risk of cervical cancer by 70 per cent.

NEWS 1130’s Jill Drews joined Amanda Wawryk and Jim Bennie on air to talk about this story. You can hear it below.