Updated Guidelines Of Pap Smear Test Can Minimize STI Screening

Updated Guidelines Of Pap Smear Test Can Minimize STI Screening

A study conducted at St. Michael’s Hospital revealed that the recent updates in the screening guidelines of cervical cancer from Cancer Care Ontario, has minimized the ratio of women undergoing STIs (Sexually Transmitted Infections) screening by up to 50%. This work was published in the peer-reviewed Canadian Family Physician.

The study was based on the patients from 5 different care facilities within St. Michael’s Hospital, a year prior to and after the guidelines were updated.

The results of the study showed:

• An evident decline of 60% in the Pap smear test
• Also a marked decline from 40% to all the way to 20% in the screening tests for 2 commonly occurring STIs (Chlamydia and gonorrhea) in 15-24 years old women

According to the leading investigator of the study as well as a family consultant physician at St. Michael’s, Dr. Tali Bogler, it had been established in the earlier times that there was a distinct association between the STI screening tests and Pap tests. With the recent updates in the guidelines, a woman is now to be screened for cervical cancer after she turns 21 with intervals that aren’t very frequent. Due to this, the frequency of women consulting their doctors for Pap tests has reduced significantly which may be a contributing factor for the reduced STI screening.

What Has Changed With The New Guidelines?

With the new guidelines in order, women weren’t supposed to be frequently screened for:

• Syphilis
• HIV
• Hepatitis C

Findings have definitely raised concern because in the past ten years, in Canada, Chlamydia has increased by up to 72% and Gonorrhea has increased by up to 53%.

The study’s investigators took in consideration the prevalence of the infections and concluded that the trend could eventually bring about harmful effects on the public scale. Since young women are very prone to developing STIs, therefore the physician must indulge in innovative and advanced ways for the screening of such infections in women below 25 years of age who are also sexually active.

Updates In The Guidelines

Prior to the updates in the guidelines, women used to get screened for cervical cancer within the period of 3 years of sexual activeness. After this, they were annually screened and with 3 normal results of Pap tests, the women were recommended to be screened at every 2 or 3 years, and this continued until they reached their 70’s.

The latest guidelines released by the Cancer Care Oriento recommended women to begin screening tests at the age of 21, provided that they are sexually active, and if the results of Pap tests come out normal then the screening should be done at the interval of as long as 3 years.

Dr. Bogler suggests that primary healthcare providers must take a step forward to initiate various STI screening programs where non-invasive techniques are employed for the assessment of STIs. Universities, colleges and high schools can be top sites to begin with, when targeting young women. As simple as urine tests and swab tests may yield accurate results that may help young women get these infections detected so they can prevent themselves from the long-term effects of the untreated infection like:

• Ectopic pregnancy
• Infertility
• Pelvic inflammatory disease

References

• Massad, L. S., Einstein, M. H., Huh, W. K., Katki, H. A., Kinney, W. K., Schiffman, M., … & Lawson, H. W. (2013). 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. Obstetrics & Gynecology, 121(4), 829-846.
• Sluss, P. M. (2017). Utilization Management Initiatives That Can Be Imported into Healthcare Systems. In Utilization Management in the Clinical Laboratory and Other Ancillary Services (pp. 287-290). Springer International Publishing.