Safety of longer intervals between Pap tests debated

Some experts argue the liquid screenings' heightened sensitivity warrants fewer tests, but many doctors prefer annual evaluation.

By Susan J. Landers, AMNews staff. Aug. 18, 2003.

Washington -- Liquid-based Pap tests are fueling new debates over how often to test patients and what to do about the false-positives that may result from these more sensitive tests.

Most women feel duty-bound to schedule a Pap test every year, and their doctors are happy to oblige because the office visits provide the opportunity for a more extensive exam.

However, some groups are cautioning that annual Pap tests using liquid preparations approved by the Food and Drug Administration in the mid-1990s are unnecessary for many women. They argue that the increased sensitivity of the new tests may result in the detection of many more abnormalities that ultimately are determined to be harmless.

Less-frequent testing could mean fewer unnecessary follow-up assessments and savings of both money and anxiety, said Debbie Saslow, PhD, director for Breast and Gynecologic Cancer at the American Cancer Society.

The cancer society's guidelines say it's OK to use the old Pap test and it's OK to use the new Pap test. "But if you use the liquid Pap, don't do it every year because you are going to get a lot of false-positives," said Dr. Saslow.

For more than 15 years, even before the liquid-based tests were on the market, the cancer society has recommended against annual Pap tests, said Dr. Saslow. But evidence of the sensitivity of the newer tests may help persuade doctors and patients to lengthen the amount of time between screenings, she said. "We concluded that if you have a test that is more sensitive, that is not going to miss much, then you can safely and with great assurance not get screened as often."