A Week Of Changes For Women's Health

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For the second time in a week, a panel of medical experts has recommended that younger women be tested less frequently for cancer. The latest advice is that women can wait until 21 to have their first Pap test for cervical cancer. Many women can skip annual Pap smears after that. The guidance comes after another recommendation earlier this week that routine mammograms needn't start until age 50. NPR digital health correspondent Scott Hensley has been following the changes and joins host Scott Simon to talk about it.

SCOTT SIMON, host:

This is WEEKEND EDITION from NPR News. I'm Scott Simon.

For the second time in a week, a panel of medical experts has recommended that younger women be tested less frequently for cancer. Latest advice is that women can wait until they're 21 to have their first Pap test for cervical cancer. Many women can skip annual Pap smears after that. Guidance comes after another recommendation, earlier this week, that routine mammograms needn't start until the age of 50.

NPR digital health correspondent Scott Hensley has been following the changes and joins us. Scott, thanks very much for being with us.

SCOTT HENSLEY: My pleasure.

SIMON: And what led the American College of Obstetricians and Gynecologists to change their advice about Pap smears?

HENSLEY: They've been sifting the accumulating medical evidence and think that the latest take is that the benefits, especially for younger women, don't outweigh the risks, and those risks would include the potential harm from biopsies and things like that as well as a psychological component of labeling young women as potential cancer patients when things may get better all by themselves.

SIMON: And is it just coincidence that these changes for screening breast and cervical cancer occur in the same timeframe?

HENSLEY: Yes, the groups were working independently, and both sets of recommendations were in the works for years.

SIMON: Some people who have been skeptical of health-care overhaul proposals suggested this week that this is a harbinger of some kind, that when you talk about the whole idea of managing care, it means rationing care. Was a connection made to the health-care debate?

HENSLEY: I think people have seized on that, and the notion in both of these cases is that less would be better, and that plays into the fears that some people have, that health-care overhaul would necessarily lead to less care as a way to save money. These recommendations were made primarily on the basis of the medical benefit versus risk and not cost. But I think it did put in bold relief the notion that - or the fear that people have that some of these government bodies might intervene in a way that would deny people care. These are voluntary recommendations.

SIMON: And of course, the concern is, though, that health insurers now might be less willing, for example, to pay for annual exams.

HENSLEY: Right, and that is a concern. Health Secretary Sebelius sought to reassure women about the recommendation, and said that the government wasn't going to change its policy immediately on the basis of this recommendation and that the government will continue to pay for mammograms.

SIMON: The tests that women were told were important for their good health, now they're going, oh, maybe they're not. How should a woman evaluate that?

HENSLEY: It's tough. I mean, these were the same groups that had different recommendations only a few years ago. I think the most important thing that a woman can do is talk about her particular case with her doctor because again, these are for populations of people. And a woman's family history or previous test results could mean that she should have the test more often than the general population would.

SIMON: Any broader lesson to be drawn from this?

HHENSLEY: I think this is the sort of thing that's going to be happening more often as comparisons are made of different kinds of treatments and tests to figure out on the evidence what makes the most sense. So it's healthy for people to debate these and think about the pluses and minuses. But the notion that we could be smarter about how we use medical tests and procedures isn't going to be - go away. That's - going to be more of this and the question is, really, is it done in a fair and smart way?

SIMON: NPR digital health correspondent Scott Hensley, thank you.

HENSLEY: Thank you.

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