Women’s Health Issues in the News….AgainWomen’s Health Issues in the News….Again The recent release of the U.S. Preventive Services Task Force (USPSTF) revised guidelines for mammograms and the American College of Obstetrics and Gynecology (ACOG) revised guidelines for pap smears brought back memories of July, 2004 when news about hormone therapy made headlines. Once again consumers must try to understand how the changes affect their health care.
Groups such as the American Cancer Society were shocked to hear that the USPSTF no longer recommends routine mammogram screening for women under the age of 50. Many mammogram clinics reported higher rates of cancellation after the announcement was released. So what is behind this new mammogram guideline?
The USPSTF first convened in 1984 and is the leading independent panel of private-sector experts in prevention and primary care. The USPSTF conducts rigorous, impartial assessments of the scientific evidence for the effectiveness of many clinical preventive services, including screening, counseling, and preventive medications. Its recommendations are considered the "gold standard" for clinical preventive services. The USPSTF evaluates the benefits of clinical services based on age, gender, and risk factors for disease. Then this group of experts makes recommendations about which preventive services should be incorporated routinely into primary medical care. Part of their assessment is also based on the negative affects of “over-diagnosis”. In other words, screening that is too frequent sometimes finds an issue that may resolve on its own, but because the issue is discovered it is often treated and treatment most often includes risk as well.
The key words to focus on are “guidelines” and “preventive”. These recommendations do not replace the need for women to discuss screening options such as mammograms and pap smears with their health care provider in order to make decisions based on personal health history and risk factors. Women with a history of risk factors or illness would fall under guidelines or protocols other than preventive.
ACOG’s revised pap smear guidelines call for an initial pap smear at age 21, with pap smears every 2 years after that. Women with three normal pap smears may go to an every 3 years screening. The concern here is that women equate a pap smear with their annual exam and may skip that annual exam since they don’t need a pap smear. Women must remember that an annual exam also includes a pelvic exam, blood pressure check, and other important health assessments.
It is important for women to continue to seek guidance from health care providers and partner with them to make the appropriate screening decisions.