(T. Anderson/blackaids.org) The American College of Obstetricians and Gynecologists (ACOG) recently released a revised set of recommendations about Pap smears, which screen for cervical cancer. Doctors now suggest that women get their first screening when they turn 21 instead of within three years of becoming sexually active. They also recommend that the tests be done less frequently--every two years instead of every year. While most health experts have signed off on the plan, others question whether it's the best idea for Black girls and women, since there is an STD epidemic in the Black community and recent research shows that about 50 percent of Black teenage girls have an active STD. We asked Linda Bradley, M.D., vice chair of ob-gyn at the Cleveland Clinic, the reasons behind the changes and whether there are exceptions that we need to be aware of. "This is about new scientific information being available," says Dr. Bradley. "Physicians now have more information to guide them in making recommendations about the frequency of a Pap smear--information about the natural history of cervical cancer and [its relationship] to the human papillomavirus (HPV). We're learning, for instance, that some women have a 'double-negative Pap smear,' which means you are so unlikely to develop precancer that doctors can defer tests unless you have been previously diagnosed with HPV." This is key, Dr. Bradley says, because overtesting could lead to unnecessary procedures that may put a woman's health at risk. "In the past when we've seen patients with HPV, [sometimes] we took out their cervixes. That type of unnecessary treatment of adolescents, for instance, can lead to infertility later--the female may not be able to conceive or could have a premature birth." Still, Dr. Bradley warns, Pap smear testing every two years beginning at 21 is absolutely crucial--not just to evaluate the health of the cervix but to allow a doctor the opportunity to check for any other possible health issues as well. ACOG states that women and girls who have been vaccinated against HPV follow the same guidelines as those who have not.

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