Health Care News

USA: Guidelines Push Back Age For Pap Smears

New guidelines for cervical cancer screening say women should delay their first Pap test until age 21, and be screened less often than recommended in the past (hat tip: G Enggas). The advice, from the American College of Obstetricians and Gynecologists, is meant to decrease unnecessary testing and potentially harmful treatment, particularly in teenagers and young women. The group’s previous guidelines had recommended yearly testing for young women, starting within three years of their first sexual intercourse, but no later than age 21.

There are 11,270 new cases of cervical cancer and 4,070 deaths per year in the United States. One to 2 cases occur per 1,000,000 girls ages 15 to 19 — a low incidence that convinces many doctors that it is safe to wait until 21 to screen. The doctors’ group felt it was safe to test women less often because cervical cancer grows slowly, so there is time to catch precancerous growths. Cervical cancer is caused by a sexually transmitted virus, human papillomavirus, or HPV, that is practically ubiquitous. Only some people who are exposed to it develop cancer; in most, the immune system fights off the virus. If cancer does develop, it can take 10 to 20 years after exposure to the virus. The new guidelines say women 30 and older who have three consecutive Pap tests that were normal, and who have no history of seriously abnormal findings, can stretch the interval between screenings to three years. In addition, women who have a total hysterectomy (which removes the uterus and cervix) for a non-cancerous condition, and who had no severe abnormalities on previous Pap tests, can quit having the tests entirely. The guidelines also say that women can stop having Pap tests between 65 and 70 if they have three or more negative tests in a row and no abnormal test results in the last 10 years.

The changes do not apply to women with certain health problems that could make them more prone to aggressive cervical cancer, including H.I.V. infection or having an organ transplant or other condition that would lead to a suppressed immune system.

Africa: Growing Use Of Cell Phones For Family Planning

The growth of cellphone use, particularly in the developing world, is providing health experts with a new channel of communication to provide family planning information. One World's Mobile4Good in Kenya uses cellphone technology to inform subscribers about opportunities for free exams or treatment, and also provides a question-and-answer service that allows individuals to ask sensitive health questions. In South Africa and Botswana, cellular technology is being used to remind people needing to take medicines at regular intervals.

Jamaica Corker of Population Services International said a project in the Democratic Republic of Congo where mobile users call a toll-free line to request family planning information and referrals to the nearest clinic or pharmacy has shown the power of mobile technology. Aside from providing family planning information, mobile phones are being used as patient monitoring devices. Mobile phones are also used to collect community and clinical health data, for sending information to health workers, researchers and patients, and to monitor patients' vital signs.

USA: Senate Health Care Bill Creates New Marriage Penalty

Senate Democrats' health care bill would create a new marriage penalty by imposing a tax on individuals who make $200,000 annually but hitting married couples making just $50,000 more (hat tip: Black & Right). That's one of 17 new taxes imposed by the bill, which also creates a levy on elective plastic surgery - some call it "botax" - and places a 40 percent excise tax on those who have generous health care plans. The new taxes would fund an expansion of government programs and to fund subsidies for lower-income individuals to buy insurance, extending health care coverage to 94% of non-elderly Americans.

Democrats said the bill will offer lower health care costs for small businesses and families, and said the new taxes are aimed at upper-income earners. They said that makes good on President Obama's campaign pledge not to increase taxes on families making less than $250,000 a year, which explains the reason for the new marriage penalty. Ryan Ellis, tax policy director at Americans for Tax Reform, said the new marriage penalty comes on top of an existing one that's always been part of the payroll tax, which funds Social Security and Medicare.