Many women get needless HPV tests for cervical cancer: Study

CBS/AP) Are doctors too quick to test their patients for human papillomavirus (HPV) - the virus that causes cervical cancer?

Maybe so. A new government study shows that a surprising number of doctors are failing to follow guidelines on how to perform HPV checks, suggesting that many women are getting unnecessary tests. That wastes money and could lead women to get medical care they don't need, says study author Dr. Mona Saraiya of the CDC.

The findings, reported in 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 the American Cancer Society's Debbie Saslow. "We have not been able to get that message across."

For decades, Pap smears - which look at cells scraped from the cervix - were the only way to screen for cervical cancer. Now doctors know that certain strains of HPV cause most cervical cancer. HPV testing isn't a replacement for the Pap, but it can yield extra information to help gauge a woman's risk in order to guide her ongoing care.

But only if it's used correctly.

The new CDC study, which looked at the screening practices of 600 health-care providers, showed that 60 percent say they give a routine Pap-plus-HPV test to women who are too young for that combination. But guidelines say so-called "co-testing" is only for women 30 or older.

Why the age limit? Saslow says HPV is nearly as common as the common cold, especially in young women - but their bodies usually clear the infection on their own. Learning that a 20-something has HPV raises the odds of more invasive testing that in turn can leave her cervix unable to handle pregnancy later on.

Young women are supposed to get HPV testing only if a Pap signals a possible problem and doctors really need the extra information.

Then there's the question of which test to use. Only a few so-called high-risk strains of HPV cause cervical cancer - and those are the ones doctors are supposed to test for. Before scientists understood the different HPV types, a test already was on the market that detects strains that can cause genital warts, not cervical cancer. The CDC's Saraiya says there's no reason to use that old test because learning you have a probably transient warts-causing strain doesn't alter your care.

Yet her study found 28 percent of doctors and clinics say they order tests for both the cancer-causing and warts-causing strains, regardless of patient age.

An HPV test costs $80 to $100, on top of a $40 Pap. Saraiya says labs can bill for two HPV tests when doctors order testing for both kinds of strains.

So what does a woman need to know before her next checkup? Guidelines from the American College of Obstetricians and Gynecologists recommend that:

-Routine Paps start at age 21

-Most women in their 20s get a Pap every two years

-Women 30 and older wait three years between screenings if they've tested negative on both Pap and  HPV tests, or three consecutive clear Paps

-If Pap is inconclusive at any age, HPV testing may help rule out who needs further examination and who can just repeat a Pap in a year

-Anyone who's been vaccinated against relatively new HPV still must follow Pap screening guidelines for their age group

-Higher-risk women, such as those with HIV or previous cervical abnormalities, need more frequent screening