Groups differ on cervical cancer testing

WASHINGTON -- Forget one-size-fits-all advice: Guidelines out Wednesday give women choices for cervical cancer testing that depend on their age.

Once recommended every year, many major medical groups have long said that a Pap test every three years is the best way to screen most women, starting at age 21 and ending at 65.

But starting at age 30, you could choose to be tested for the cancer-causing HPV virus along with your Pap -- and get checked every five years instead, say separate guidelines issued by the U.S. Preventive Services Task Force, the American Cancer Society and some other organizations.

It's not a requirement -- women 30 and older could stick with the every-three-years Pap, the guidelines say. But if they choose the newer Pap-plus-HPV option and the results of both tests are negative, the guidelines conclude it's safe to wait a bit longer for the next cervical check. That's because certain strains of HPV, the human papillomavirus, cause most cervical cancer, but the infection has to persist for a number of years to do its damage.

The cancer society already said women 30 and older could use both tests, but draft recommendations issued last fall by the task force, which advises the government, didn't include that option. The task force has since reviewed additional evidence and rewrote its final guidelines so the medical groups now agree.

The new guidelines also say:

A stand-alone HPV test, without a Pap, isn't recommended.

Women over 65 can end screening if they have had several negative tests in a row over a certain time period. But women in that age group who have a history of pre-cancer should continue routine screening for at least 20 years.

The cancer society says women who have gotten a new vaccine against HPV still need routine screening.