A unique study from New Mexico, which took into account all information from the entire state, regardless of the women’s insurance provider, insurance coverage, healthcare provider, and location, shows that screening every 3 years dramatically reduces the rate of cervical cancer.
It also shows that 3 years is a safe interval, inasmuch as more frequent screening does not improve detection rates. Yet many women are being screened more frequently, which wastes healthcare resources, say the researchers.
The study was published in the International Journal of Cancer.
“A central value of our paper is that it does show safety for screening at 3-year intervals, which are recommended for the Pap smear alone,” said lead author Cosette Wheeler, PhD, Regent’s Professor of pathology, obstetrics, and gynecology at the University of New Mexico School of Medicine, Albuquerque.
“We found there is no additional benefit from screening more frequently, as there is excellent prevention of early-stage cervical cancers and over 80% of later-stage nonlocalized stage cervical cancers,” she said.
Wheeler said that over the years, different guideline recommendations on cervical cancer screening have been issued by various US societies and organizations and that national guidelines issued in 2012 and updates from 2015 do not recommend screening more than every 3 years, regardless of age, for women who are not under surveillance for prior abnormalities.
“But through 2018, the New Mexico HPV Pap Registry shows that about half of all women are still being screened annually and biennially, which demonstrates a waste of healthcare dollars,” she told Medscape Medical News.
“Potentially millions of dollars could be saved for New Mexico and beyond in the rest of the United States if we were actually screening every 3 years,” she added.
“Importantly, this observation may reflect that clinicians and patients are not certain that 3-year intervals are safe,” she added. “Following these guidelines changes a process that worked for many decades and is what both clinicians and patients are used to, but our data reassure everyone that 3-year screening intervals are appropriate.”
At the same time, a growing number of women appear to be falling behind in their screening. “There are more women who are not screening after more than 5 years, and that proportion is increasing over time,” said Wheeler. “Women who are getting only Pap tests have the largest increase in not coming back.”
Intervals between screenings are also increasing among women who undergo co-testing, albeit not as dramatically.
REFERENCE: Landy et al: Impact of screening on cervical cancer incidence: A population‐based case–control study in the United States; https://onlinelibrary.wiley.com/doi/full/10.1002/ijc.32826