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Automated tests 'don't represent standard of care'
The nation's most prominent group of obstetricians and gynecologists says Papnet and other automated Pap smear technologies "cannot be recommended based on costs and the lack of sufficient data."
That word of caution comes from the American College of Obstetricians and Gynecologists (ACOG) in Washington, DC. ACOG's trepidation is all the more noteworthy when you remember that its members are among the hardest hit by malpractice claims, making them eager to reduce liability risks whenever possible. Nevertheless, an ACOG committee did not find enough value in automated Pap smear screens.
ACOG's Committee on Gynecologic Practice released a statement saying that "these technologies do not represent the standard of care in cervical cancer screening." ACOG goes on to say that "while the new techniques improve on the sensitivity of the Pap test, their routine use cannot be recommended based on costs and the lack of sufficient data demonstrating whether they reduce the incidence of or improve the survival rate from invasive cervical cancer."
ACOG says the use of the new techniques "does result in a reduced number of false-negative Pap tests, but that most of these results are classified as low-grade lesions or atypical squamous cells of undetermined significance." Treating women with those conditions is controversial, since most of those cases do not turn out to be cancer.
The committee says it released the statement "partly in response to aggressive direct-to- consumer advertising that led many women to feel they are at greater risk for undiagnosed cervical cancer if they don't use the latest technology."
Papnet is not without its advantages, the committee notes. Chief among the advantages are the ability to read smears with very few diagnostic cells on the slide and the ability to diagnose small-cell cancers. But those benefits are outweighed by the additional cost, estimated by ACOG as $35 per slide, and the additional time for rescreening the slides.