Is there such a thing as too much caution or testing when it comes to preventing or detecting cancer?  Certainly the type of testing that calls for an invasive procedure or exposure to radiation would be subject to balancing the risks against the potential value.  Cervical cancer testing however has traditionally been limited to a Pap Test which involves little if any risk.  The recent addition of HPV (Human Papillomavirus) testing along with a Pap Test is also of little or no risk.  One might conclude then that what's the harm of annual testing?

In the past, the rule was simple–every woman over age 21 on an annual basis. Guidelines for cervical cancer testing now involve the age of the woman (age 30 and over versus under age 30) as well as the results of previous Pap and HPV tests.   Women under age 30 do not benefit and are at "risk" financially and medically if an HPV test is performed.  Women age 30 and over do not benefit from Pap/HPV testing more than once every 3 years.  A recent Centers for Disease Control and Prevention study, however, shows that not all doctors have received the message.

• 60% of doctors surveyed routinely order the HPV test for women under age 30, despite there being evidence (as well as the guideline) that indicate the HPV test is not appropriate at the younger age.
• 28% of the same pool of doctors also order two HPV tests (one that tests for cancer risk and one that tests for a form of HPV that does not cause cancer).

This excess testing is leading to increased costs (each of the HPV tests runs about $80-$100).  In addition, testing women under age 30 for HPV leads to positives that cause anguish and additional unnecessary medical procedures.

HPV is nearly as common as the common cold, especially in younger women — but their bodies usually clear the infection on their own and only a years-long infection is risky. Learning that a 20-something has HPV increases the odds of more invasive testing that in turn can leave her cervix less able to handle pregnancy later in life. Younger women are supposed to get HPV testing only if a Pap signals a possible problem and doctors really need the extra information.

Docs Over Testing for Cervical Cancer Virus

So what should a woman know about cervical cancer testing?  The CDC put together a wonderful booklet that provides information that will help a woman determine what testing should be done based on her particular circumstances.  It also provides an excellent narrative to mitigate the anxiety that naturally comes with a abnormal pap test or positive HPV test.  I highly recommend it to anyone who wants to increase their awareness on this topic.