January 31, 2005 Since it was first introduced six decades ago, the Papanicolaou (Pap) smear widely credited with substantial reductions in the incidence and mortality from cervical cancer has become an annual screening rite among American women. Recently, however, long-accepted Papanicolaou smear screening standards have been re-examined. Current recommendations from the American College of Obstetricians and Gynecologists, the American Cancer Society and the US Preventive Services Task Force stipulate that screening intervals can be extended to every 2 to 3 years in women over age 30 with more than 3 prior normal test results and that most elderly women can cease screening. But are woman willing to forego their annual test?

In a study published in the current issue of The American Journal of Medicine researchers at the VA Outcomes Group (White River Junction, Vermont), Dartmouth Medical School, and the Norris Cotton Cancer Center examined the beliefs and attitudes of 360 women aged 40 or older about reducing Pap testing frequency and eventually stopping the test completely. When questioned about their preferences for screening, 75% preferred screening at least annually (12% chose screening every 6 months). More than two thirds said that they would try to continue being screened annually even if their doctors recommended less frequent screening and advised them of comparable benefits, and only 35% thought that there might come a time when they would stop getting Papanicolaou tests. The most powerful drivers of attitudes toward screening intensity were a habit of annual screening, a woman's perceived risk of cervical cancer, and her belief that cost was the basis of current screening frequency recommendations.

Writing in the article, Brenda E. Sirovich, MD, MS, states, "One of the most powerful determinants of higher perceived risk of cervical cancer was having had an abnormal test result. A self-fulfilling cycle ensues: more annual screening le
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Contact: Pam Poppalardo
ajmmedia@elsevier.com
212-633-3944
Elsevier Health Sciences
31-Jan-2005

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