Study: Doctors overtest for cervical cancer virus

6/21/2011

WASHINGTON -- Too many doctors are testing the wrong women, or using the wrong test, for a virus that causes cervical cancer.

The days of one-size-fits-all screening for cervical cancer are long gone. How often to get a Pap smear -- and whether to be tested for the cancer-causing HPV virus at the same time -- now depend on age and other circumstances.

But a government study reported Monday that a surprising number of doctors and clinics aren't following guidelines from major medical groups on how to perform HPV checks, suggesting a lot of women are getting unnecessary tests.

That wastes money and could harm women who wind up getting extra medical care they didn't need, says Dr. Mona Saraiya of the Centers for Disease Control and Prevention, who led the research.

Even she wasn't protected from the confusion. Dr. Saraiya was stunned to get a bill showing that her own doctor had ordered testing for HPV strains not connected to cervical cancer.

The findings, reported in the journal Obstetrics & Gynecology, show women have to be savvy to ensure they're getting the right checkups -- enough, but not too much.

"It's extremely discouraging," says Debbie Saslow, gynecologic cancer director at the American Cancer Society, who's had to argue with her doctor against testing too often.

Cervical cancer grows so slowly that Pap smears -- which examine cells scraped from the cervix -- usually find it in time to trea, or even to prevent when precancerous cells are sighted and removed.

For decades, Pap smears were the only way to screen for cervical cancer. Now doctors know that certain strains of HPV, the human papillomavirus, cause most cervical cancer. HPV testing isn't a replacement for the Pap. But it can provide extra information to help determine if a woman is at higher or lower risk and thus guide her ongoing care -- if it's used correctly.

The new CDC study, part of a national survey of medical practices that included 600 providers of cervical cancer screening, examined how doctors are using it.

The study found 60 percent of doctors and clinics say they give a routine Pap-plus-HPV test to women who are too young for that combination. Guidelines emphasize that so-called co-testing is only for women 30 and older. If both tests are negative, they can wait three years before their next screening.