Women's Health

Many older women prefer to have annual Pap tests

In the recent past, most physicians required women over 30 to have three consecutive normal Papanicolaou (Pap) tests annually before they would allow them to undergo cervical cancer screening at less frequent intervals. However, because a test for the human papillomavirus (HPV), which can cause cervical cancer, has been available since 1999, some organizations have changed their screening guidelines to allow women over 30 to be tested for cervical cancer every 3 years if they have both a negative HPV test and a normal Pap test.

Researchers at the University of California, San Francisco, interviewed 865 white, Latina, black, and Asian women aged 50 to 80 in San Francisco regarding their preferences for cervical cancer screening. A third of the women had heard of HPV, which has been featured frequently in the media in recent years. Sixty-four percent of the women said they would want to be tested for HPV if the test were available, and an additional 17 said they would want to be tested if their physician recommended it. Of these women, more than 90 percent said they would want to have Pap tests more often than once a year if their HPV test were positive. More than half of women younger than 65 were willing to have Pap tests every three years if they had negative HPV tests and normal Pap tests, and half the women over 65 were willing to stop having Pap tests altogether after a negative HPV test and normal Pap test.

The authors suggest these results indicate a large proportion of women are interested in using HPV tests to determine how often they should be screened for cervical cancer. However, nearly half the women over 65 indicated they would want to continue having annual Pap tests, even if their HPV tests were negative. This desire for continued testing runs contrary to the U.S. Preventive Services Task Force recommendation that once women reach 65, routine screening for cervical cancer can stop. Also, a third of women under 65 said they would still want annual Pap tests, even if their HPV tests were negative. This study was funded in part by the Agency for Healthcare Research and Quality (HS10856).

See "Preferences for human papillomavirus testing with routine cervical cancer screening in diverse older women," by Alison J. Huang, M.D., M.Phil., Eliseo J. Pérez-Stable, M.D., Sue E. Kim, Ph.D., George Sawaya, M.D., and others in the October 28, 2008, Journal of General Internal Medicine 23(9), pp. 1324-1329.

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