Screening Tests for Young Adults (Ages 19-29)

Most deaths from cancer of the cervix (the lower part of the uterus, or womb) can be avoided by having regular checkups and Pap smears. This is a slow-growing cancer that can take several years to develop. Most often, cancerous cells are seen in women 40 years of age or older. Routine screening can help identify cervical cancer early on, at a time when it is highly curable. Screening even finds precancerous lesions that can be monitored or removed before cancer ever starts to develop.

Pap smear recommendations for young women may vary somewhat, depending on individual circumstances, according to the American College of Obstetricians and Gynecologists (ACOG).

• A Pap smear for women younger than 21 is not recommended because the incidence of cancer in this age group is rare. False positive results may occur due to normal cell changes and are somewhat common. The false positive results may generate unnecessary and costly treatment as well as emotional anxiety.
• Women between the ages 21 and 29 should have a Pap smear every two years.

Recommendations from the American Cancer Society and the U.S. Preventive Services Task Force differ somewhat:

• Begin getting Pap smears about 3 years after your first vaginal intercourse, but no later than 21 years of age. Then, get tested each year until age 30.

Pap smears are available from family planning clinics and public health departments as well as from health care providers (including pediatricians, family physicians, obstetrician-gynecologists, and nurse practitioners).

HPV testing
In general, screening for the presence of human papilloma virus (HPV DNA test) is not recommended in women younger than age 30 because infections with HPV are relatively common in this age group and often resolve without treatment or complications. It is recommended that women 21 years old or older be screened for HPV in addition to the Pap smear only if the Pap smear shows abnormal results.

Even if you do not need a Pap test each year, for most women, an annual gynecologic and pelvic exam is still recommended, reminds the ACOG.

Links
College of American Pathologists: MyHealthTestReminder.com - Pap Tests.

Sources

(December 2009). American College of Obstetricians and Gynecology Practice Bulletin Number 109, Cervical Cytology Screening. PDF available for download at http://journals.lww.com/greenjournal/documents/PB109_Cervical_Cytology_Screening.pdf through http://journals.lww.com. Accessed December 2009.

American Cancer Society. DES Exposure: Questions and Answers. Available online at http://www.cancer.org/docroot/CRI/content/CRI_2_6x_DES_Exposure_Questions_and_Answers.asp through http://www.cancer.org. Accessed September 2008.

American College of Obstetricians and Gynecologists. Cervical cancer screening: testing can start later and occur less often under new ACOG recommendations (press release). 31 Jul 2003. Available on the Internet at http://www.acog.org/from_home/publications/press_releases/nr07-31-03-1.cfm through http://www.acog.org. Accessed 15 Jul 2004 and 18 Jan 2008.

American College of Physicians. New pap guidelines reduce screening, but raise concerns about compliance. Apr 2003. Observer. Available on the Internet at http://www.acponline.org/journals/news/apr03/pap_guides.htm?hp through http://www.acponline.org. Accessed 15 Jul 2004 and 18 Jan 2008.

American College of Obstetricians and Gynecologists. Human papillomaviruses and cancer: questions and answers. 8 Jun 2006. Available on the Internet through http://www.medem.com. Accessed 18 Jan 2008.

American Society for Colposcopy and Cervical Pathology. What women should know about HPV and cervical health. 2003. Available on the Internet at http://www.asccp.org/patient_edu.shtml through http://www.asccp.org. Accessed 17 Jan 2008.

Solomon D, Papillo J, Davey D, on behalf of the Cytopathology Education and Technology Consortium. Statement on HPV DNA Test Utilization. Am J Clin Pathol 2009;131:768-769.

US Centers for Disease Control and Prevention. Basic facts on screening and the Pap test. Oct 2003. PDF available for download at http://www.cdc.gov/cancer/cervical/pdf/cc_basic.pdf through http://www.cdc.gov. Accessed 2 Aug 2004 and 18 Jan 2008.

US Food and Drug Administration. Cervical Cancer Screening. FDA Consumer Magazine. January-February 2004. Available online at http://www.fda.gov/Fdac/features/2004/104_cancer.html through http://www.fda.gov. Accessed September 2008.