By Dr. Janet Matthews
The field of women’s health has been plagued by confusion and consternation the past week and a half, as two different organizations have issued new guidelines concerning screening tests recommended for women.
The brouhaha began on Nov. 16, when the U.S. Preventive Services Task Force issued guidelines which changed their previous advice for screening mammograms. Rather than recommending annual mammograms beginning at age 40, the Task Force now recommends that screening not begin until age 50 unless high risk conditions are present.
The Task Force also recommends that consideration be given to discontinuing screening at age 75, and that self-breast exams not be recommended or taught by doctors.
Before you all cancel those mammogram appointments which I have talked you into, however, you should know that the Preventive Services Task Force advice is not backed by other professional organizations.
The American Cancer Society and the American College of Obstetricians and Gynecologists both state that they stand by their recommendation that screening mammograms begin at age 40, and that self-breast exams can be helpful for detecting breast cancers.
The American College of Obstetricians and Gynecologists caused its own stir this past week, however, when it issued new guidelines for cervical cancer screening — the Pap smear.
These new guidelines state that Pap smears should not begin until age 21, and that from 21 to 29 the screening should be done only every other year. This recommendation applies only to those women without additional risk factors, such as previous cervical dysplasia.
My point in discussing these new guidelines today is not to further confuse the issue, or to change any recommendations I have written in the past.
What I want to have you understand is that all the new recommendations flooding the news are guidelines only — recommendations, not rules.
The new guidelines from the Preventive Services Task Force and from the American College of Obstetricians and Gynecologists are based on trying to find the right balance between detecting disease and causing harm from too aggressive screening or treatment.
The decreased screening recommended in these guidelines in not based primarily on the cost of the testing, as some people have theorized, but rather on potential harm from false-positive screening tests or from treatment of very early conditions which can resolve spontaneously.
The best way to judge where this balance falls for your own individual set of risks and benefits is to consult with your own doctor. He or she can use the guidelines as a starting point to decide exactly which screening tests are important for you, and when they should be done.
As always, the bottom line for any medical advice should be to discuss with your doctor how the advice applies to your own health and circumstances. The goal is a healthier and happier you. How’s that for an ultimate guideline?
Dr. Janet Matthews is the OBGYN physician at The Women’s Center, a service of Muskogee Regional Medical Center, 687-3050. Send questions, comments or suggestions for future columns to janet.matthews@capellahealth.com.
