Chicago Area Local News

CHICAGO (CBS) ― Earlier this week, a government task force released new mammogram recommendations.

Now, as CBS 2's Mai Martinez reports, another set of new medical recommendations is causing concern among women.

For decades, American women have been told they need to get a pap smear every year, but new recommendations released Friday could be changing that.

The American College of Obstetricians and Gynecologists, or ACOG, now recommends women between the ages of 21 and 30 be screened once every two years for cervical cancer, and women age 30 and older just once every three years, if they've had three consecutive negative test results.

They also moved the baseline to start screening to 21 years of age.

Rush University Medical Center's Dr. Jacob Rotmensch says the reason is simple.

"The concern is, amongst many of us, is that pap smears that show mild changes often can be followed conservatively without doing a surgical procedure on a patient," Rotmensch said.

He said the recommendations have been out there for a while in his field, and they're supported by data that shows cervical cancer rates have fallen more than 50 percent in the past 30 years.

According ACOG, the incidence of cervical cancer fell from 14.8 per 100,000 women in 1975 to 6.5 per 100,000 women in 2006.

Still, many women are leery of the new recommendations.

"If you don't do it every year, you might get cancer, and if you're going to wait three years, that doesn't make any sense to me," Lucy Moriskis.

She added it's all a bit much to process, especially following this week's new mammogram recommendations.

"Well, they're confusing us that's for sure, but I'm going to stick to what I believe in, and I'm just going to continue on to see my doctor and take care of my health," Moriskis said.

While he agrees with ACOG's new recommendations, Dr. Rotmensch says every woman's situation is different, and they should discuss it their own physicians and decide how best to proceed. He also pointed out the recommendations are merely meant as a guideline.

Dr. Lauren Streicher, an OB/GYN and an assistant professor at Northwestern, says most young women with abnormal pap tests don't have anything seriously wrong with their cervix and that problems usually clear up on their own.

But she stressed women still need to see their OB/GYN every year for things like breast and pelvic exams.

"So you still have to go; you're not off the hook," Streicher said.

The change by the American College of Obstetricians and Gynecologists comes amid the completely separate debate over when regular mammograms to detect breast cancer should begin. The timing of the Pap guidelines is coincidence, said ACOG, which began reviewing its recommendations in late 2007 and published the update Friday in the journal Obstetrics & Gynecology. 

The guidelines also say:

• Women 30 and older should wait three years between Paps once they've had three consecutive clear tests. Other national guidelines have long recommended the three-year interval; ACOG had previously backed a two- to three-year wait.
• Women with HIV, other immune-weakening conditions or previous cervical abnormalities may need more frequent screening.

Cervical cancer is caused by certain strains of the extremely common sexually transmitted virus called HPV, for human papillomavirus. There is a new HPV vaccine that should cut cervical cancer in the future; ACOG's guidelines say for now vaccinated women should follow the same Pap guidelines as the unvaccinated.

But the updated guidelines reflect better understanding of HPV. Infection is high among sexually active teens and young adults. Women's bodies very often fight off an HPV infection on their own without lasting harm, although it can take a year or two. The younger the woman, the more likely that HPV is going to be transient.

Moreover, ACOG cited studies showing no increased risk of cancer developing in women in their 20s if they extended Pap screening from every year to every two years.

As for adolescents, ACOG said cervical cancer in teens is rare - one or two cases per million 15- to 19-year-olds - while HPV-caused cervical abnormalities usually go away on their own, and unnecessary treatment increases the girls' risk of premature labor years later.

• U.S. Preventive Services Task Force's Suggestions
• American Cancer Society: Performing Breast Self-Exam
• National Cancer Institute Explains A Mammography
• Federal Government Web Site On Women's Health
• American Congress Of Obstetricians And Gynecologists Response To New Mammogram Guidelines 

CBS 2's Anne State, CBS News and The Associated Press contributed to this report.

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