Women with normal Pap tests can limit future tests

Women who have received three consecutive normal results on Pap tests can safely limit future testing to just once every three years, according to a study in the October 16 issue of the New England Journal of Medicine. Researchers reviewed the medical records of about 1 million women who received Pap tests between 1991 and 2002. Using a mathematical model, they determined that women ages 30-64 who received normal results on three consecutive annual Pap tests could increase their screening interval from one to three years with little additional risk of developing cervical dysplasia or cervical cancer during the lengthened window between exams. Women ages 21-30 and 65 and older, as well as any woman with an inconclusive Pap test or one that shows signs of precancerous cells in the cervix should still be screened every year, the researchers say. The study's findings support the American College of Obstetricians and Gynecologists's updated guidelines on Pap testing released in August. Those guidelines say a woman's first Pap test should be given three years after first sexual contact or at age 21, whichever comes first. Women ages 21-30 should be screened annually, but after age 30, tests can be given every two to three years for women who have received normal results on previous tests, according to the guidelines. HIV-positive women should be screened annually because they are at a higher risk for developing cervical cancer, an AIDS-defining illness.