ACOG says Pap smear not recommended for girls under 21

The American Congress of Obstetricians and Gynecologists (ACOG) has released new guidelines advising against annual Pap tests for women younger than age 21. The agency says younger girls will generally only show evidence of  human papillomavirus (HPV), which it says rarely leads to cervical cancer for women younger than 21. The findings were reported by MSNBC.

The only exception, according to the ACOG, is for adolescents with compromised immune systems, due to conditions such as HIV infection, organ transplant or long-term steriod use. This group makes up less than 1 percent of adolescents, but they are more at risk that HPV could develop into cancer.

However, the ACOG is quick to say that Pap tests are still the best defense for early detection and treatment of precancerous cells that could eventually lead to cervical cancer. They still recommend women 21 and older undergo regular Pap tests. According to the MSNBC report, cervical cancer rates in the United States have dropped by more than half in the past 30 years, which is largely attributed to cervical cancer screening – the Pap test.

Recently, there has been some debate about a relatively new vaccine offered by Merck pharmaceuticals, Gardasil. The vaccine is promoted as a preventive treatment for cervical cancer, and is being marketed for girls beginning at around age 9-11. The vaccine is given in a series of three shots.

However, Gardasil also has been associated with serious adverse events, including more than 50 reports of deaths that may be linked to the vaccine. Additionally, the vaccine doesn’t last for more than five years, meaning that any potential benefit it might provide is likely to be inactive by the time the girl is old enough to be sexually active. HPV is a virus transmitted through sexual activity.

In fact, at the International Public Conference on Vaccination in 2008, the lead researcher in the development of the Gardasil vaccine, Dr. Diane Harper, stunned the assembled audience when she said the vaccine is unnecessary at best, and dangerous, at worst. She cited the risk of serious side effects as an argument against the drug, and instead recommended the proven protection against cervical cancer – regular Pap tests. She even called Gardasil “a great big public health experiment.”

Pap tests – often also called Pap smears – are effective because HPV is a slow-moving virus, which generally causes pre-cancerous lesions that may develop into cancer over time. A Pap test will detect these pre-cancerous cells, which can be treated.