What is the rationale behind this medical recommendation?

General Questions
#1

My 69-year-old mother told me that her doctor, who has been her family physician for the last 20 years or so, told her that she does not need to get the yearly Pap smear after age 70, but she still needs to get the yearly pelvic exam. She was told that Pap smears are totally unnecessary for women 70 and older, unless the woman is having a lot of sex with a variety of partners. (And that would not be my mother. Trust me.)

Huh? Cervical cancer doesn’t happen to women over 70? And why not just do the Pap during the pelvic exam? It’s just that little Q-tip swab on a long stick, if I’m not mistaken…

Is this standard practice, now? Or does she need to find a new doctor? Sonehow, it doesn’t ring true to me.

Any medical professionals want to enlighten me?

#2

That’s pretty much standard. If the woman has had 3 normal pap smears between age 60 and 70, it doesn’t appear that pap testing is a useful test after that age. Cervical cancer seldom strikes after that age, and the risk of false positive test results with resultant biopsies and their complications make the screening test riskier than the disease.

You don’t want to do a screening test that causes more harm than good. And in the healthy post 70 crowd, it looks like it just might do that.

#3

Oh, and here’s the obligatory link discussing the issue: http://www.cancerfacts.com/Home_News.asp?NewsId=1607&CB=14&CancerTypeId=4

#4

PAP smears test for cervical cancer, which is caused by certain strains of HPV, which are sexually transmitted. Many women acquire these strains and DON’T get cancer, but virtually every woman who gets cervical cancer has one of these papilloma viruses. So if you haven’t gotten cancer in the last ten years and you haven’t had new sexual partners in that time, it’s probably not necessary to have PAP smears. Unless you have HIV disease. A woman with HIV, at any age, should continue to get PAP smears because - with HPV also present - she is more likely to develop cancer.