‘Can you say form of Population Control?’ Or is it Dollar Signs in their eyes?

Many women get needless HPV tests for cervical cancer

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 groupsource

What Men Need to Know About HPV

Men most often have two types of questions or concerns when they first hear about HPV: What are their own risks from HPV, and how can they help protect their partners?

Additional information on HPV and men can be obtained from the Centers for Disease Control and Prevention’s fact sheet.

• Do men get HPV?
• How common is HPV in men?
• What are the symptoms of the HPV virus?
• Is there an HPV test for men?
• What should you do if you have genital warts? Should you stop having sex?
• Should you stop having sex with your partner if she finds out?
• What can you do to protect yourself, and your partner?
• Is there an HPV vaccine for men?

Q

Do men get HPV?

A

Yes, men get HPV in the same way women do, through intimate (genital) skin-to-skin contact – usually through sexual intercourse (vaginal or anal). However, HPV rarely causes serious health problems in men, particularly in those who have healthy immune systems.

Q

How common is HPV in men?

A

HPV is very common in both men and women. It’s difficult to develop specific estimates for men, since large studies among males have not been done in the United States, and an FDA-approved HPV test for men is not available. However, the Centers for Disease Control and Prevention estimates that more than half of American men will get HPV at some point in their lives.