I explain to my patients the difference between cancer screenings between Pap smears and pelvic exams. I tell them "my hands are the only recommended screening method for uterine and ovarian cancer." I also do a speculum exam without Pap to look for obvious vaginal and cervical lesions. I think we should advise our patients that yearly pelvic exams are needed, but Pap smears only every 3-5 years. There is also benefit to pelvic exams in women over 65 as the incidences of uterine and ovarian cancer continue to increase with age. Only cervical cancer decreases with age.
Guidelines Agree on Cervical Cancer Screening — Physician’s First Watch
Guidelines Agree on Cervical Cancer Screening
Two similar sets of guidelines recommend that most women get screened for cervical cancer every 3 to 5 years.
The principal recommendations from the U.S. Preventive Services Task Force (in the Annals of Internal Medicine) and the American Cancer Society and related organizations (in Ca: A Cancer Journal for Clinicians) include:
Women between ages 21 and 65 without risk factors (such as DES exposure or immunodeficiency) should undergo cytologic screening every 3 years.
Those aged 30 to 65 wishing to extend the screening interval could undergo screening with both cytologic exam and human papillomavirus testing every 5 years.
Women younger than 21 should not be screened.
Women older than 65 who have been adequately screened previously should not be screened.
Reader Comments (3)
The new guidelines are clear on how often to do cytology, but what about the REST of the pelvic exam?
Competing interests: None declared
On the same day I read this summary, the March/April 2012 issue of CA: A cancer journal arrived. On page 131 is a table of ACS cancer screening recommendations. http://onlinelibrary.wiley.com/doi/10.3322/caac.20143/pdf The cervical cancer recommendation is drastically different. Did ACS not have to foresight to compare information published in the same week? How confusing for clinicians!