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Cervical Cancer Test Overhaul

Hoping to spare women from unnecessary, invasive medical procedures, the American Cancer Society is saying for the first time that those who run a low risk of developing cervical cancer do not need to get Pap tests.

The society's last guidelines, issued in 1987, recommended that all women at least 18 years old receive a Pap test and a pelvic exam yearly; the test could be performed less frequently if a woman had three consecutive, normal exams.

The new guidelines say testing isn't needed for young women who are not sexually active; women 70 or older who have had normal Pap tests in the past; and women who have had hysterectomies for non-cancer-related reasons.

The guidelines say sexually active women should begin getting Pap tests within three years of the start of sexual activity, but no later than age 21.

The problem with Pap tests, according to the experts who wrote the new guidelines, is that they detect non-cancerous lesions, causing doctors to perform additional tests that needlessly worry patients, cost money and sometimes have harmful effects, such as reduced fertility.

The goal is to "diminish the number of invasive procedures done to prove a woman doesn't have cancer," said Dr. Carmel Cohen, a professor of obstetrics and gynecology at New York's Mount Sinai Medical Center who led the society's review committee.

Newer types of Pap tests allow women to be tested every two years instead of yearly with the traditional Pap test, the guidelines said.

Dr. Daron Ferris of the Medical College of Georgia said the society's guidelines are reasonable, but he said he will still be careful.

"I think you still need to exercise good judgment," he said. "No woman wants to have cervical cancer and find the test didn't find it."