For those at average risk of breast and cervical cancer, it has been a busy week! Last week new, more lenient mammography guidelines were recommended, stirring up controversy among cancer organizations and political cynics. Today, we see changes in cervical cancer screening guidelines, issued by The American College of Obstetrics and Gynecology (ACOG). Like the updated mammography guidelines, ACOG is recommending less Pap smear tests for women of average risk of cervical cancer. Women who have had abnormal cervical screenings should continue to follow their doctors recommendations as the new guidelines only apply to women of average risk.

New Guidelines Suggest:

• Women should have their first period at age 21. Old guidelines recommended women have their first Pap when they become sexually active or at age 21 -- whichever came first.
• Women in their 20's should have a Pap smear every two years, instead of annually. Women in their 30's and have had three consecutive normal Pap smears should have undergo screening every three years.
• Women 65-70, who have have three normal Pap smear results consecutive and no abnormal findings in 10 years, can discontinue screenings altogether if they choose.
• Women who have undergone a total hysterectomy due to a noncancerous condition and have not had previously abnormal Pap smears can also discontinue screenings.

Shouldn't We Be Screening More Often?

Unlike a lot of cancers, cervical cancer is very slow growing. It can take up to 8-10 years for cervical cancer to develop. New guidelines give ample time to catch any cases of cervical pre-cancer before it progresses into cancer. Conspiracy theorists argue that these new guidelines for cancer screenings are among a grand plan by the Obama administration to cut costs for healthcare reform. I completely disagree. There have been talks of updating guidelines for years now. Medically, it makes perfect sense to increase the time between Pap smears and there isn't a huge debate among cancer organizations about the new changes. Now, the breast cancer screening debate is a whole different ballgame. Check out About.com's Breast Cancer site's heated discussion about the new changes.

Anal cancer has been put in the spotlight with Farrah Fawcetts's battle with the disease. What many people are starting to learn is that a common virus, HPV, is a major risk risk factor for developing anal cancer.

HPV is a virus transmitted thorugh sexual contact and it is estimated that over 20 million Americans are infected. There are over 100 different types of HPV, however only a few are responsible for cancer development. HPV is also the leading cause of cervical cancer, a disease that plagues of 9,000 American women each year. The good news is that most cases of HPV clear up on their own before progressing to cancer. However, a regular Pap smear is needed to monitor any changes in the cervix that may lead to cervical cancer. The bottom line is that if you don't get a Pap smear, you are more at risk of developing cervical cancer.

The FDA has given their approval to expand the use of Gardasil to include males. The vaccine, which provides protection against the human papillomavirus (HPV), is targeted for males ages 9 to 26. It will help prevent two strains of HPV known to cause genital warts in both men and women. The vaccine has not yet been included in the CDC's vaccine schedule for males, but it is likely to be included. Until Gardasil is included in the vaccine schedule, most insurance companies will not likely cover the cost of the vaccine, which is about $360. The good news is that the CDC is expected to meet next week to discuss Gardasil's inclusion, so there shouldn't be too long of a delay in getting males vaccinated.

• What Parents of Boys Need to Know About the HPV Vaccine

I have always practiced safe sex by using a condom, but my doctor says that I have HPV. How is this possible? Don't condoms prevent HPV?
-An About.com Cervical Cancer reader

It's common knowledge that condoms provide excellent protection against unwanted pregnancy and sexually transmitted diseases, but how do they fare against the human papillomavirus (HPV)? Most people are unsure about whether condoms provide protection and it's a growing concern as people become more aware about HPV.

Read: Condoms and HPV to find out how much protection condoms provide against the cancer causing virus.

_{Photo (c) Bill Davenport}

Recently, a reader posted a question about whether you should tell your partner if you have HPV. HPV is a common virus with serious health consequences, but is it so common that we underestimate the health effects? I spoke to a group recently who had mixed feelings about telling their partner. Here are some of the responses:

"It's not like it AIDS. My business is my business."

"Absolutely! Your partner has a right to know if you have a illness."

"It's too embarrassing. I would die before I told my girlfriend."

Some felt honesty was the best policy, but a strong majority felt it would be too awkward to tell their partner. What would you do?

Poll: Should You Tell Your Partner that You Have HPV?

• Yes
• No
• Depends on the relationship
• View Results

More About HPV

• What is HPV?
• HPV Symptoms
• How to Prevent HPV

Too many women go without having regular Pap smears because they are uninsured and cannot afford the out of pocket expense. Thanks to federal and state programs, no woman has to go without having a regular Pap smear - regardless of income or insurance coverage. Help is available - women just need to know where to look!

• FAQ: How Much Does a Pap Smear Cost?
  
• How to Get a Free or Low Cost Pap Smear

Regular Pap smears are vital to optimum cervical health. This means having one on a regular basis - as directed by their doctor. A Pap smear is not a diagnostic test, but a screening tool. Screening tests identify abnormalities when the patient has no symptoms, while a diagnostic test helps identify the cause of symptoms in the form of a diagnosis of illness or disease. The Pap smear helps identify women who are at high risk of developing cervical cancer. Since it is not considered a diagnostic tool, it is essential that women have one regularly.

_{Photo (c) Muriel Miralles de Sawick}

When it comes to cervical cancer, it's best not to rely on symptoms to alert you that something may be wrong. Cervical cancer is a complicated disease that normally doesn't produce symptoms until the cancer has spread. Then cervical cancer symptoms begin to appear. Read more about cervical cancer symptoms...

Want to Check Your Symptoms?

Learning what your symptoms may be caused by is only a click away with the About.com Symptom Checker! It is an interactive program that allows you explore what your symptoms could mean based on important factors like age and gender. Plus, the information is provided by Harvard Medical. Check your symptoms...

I know the feeling of getting a call from your gynecologist's office two weeks after having a Pap smear. You have been expecting a card in the mail with "Normal Results" checked, but instead you have received a call from the receptionist. It has to be one of the the most stressful, panic stricken phone calls you will ever receive. The receptionist can't tell you anything specific and only offers you an appointment. So, you are left with worry and anxiety until you actually see your doctor.

My first ASCUS Pap smear result came long before I knew anything about gynecology or anything medically related for that matter. My doctor casually said "You have an ASCUS Pap result. Come back in 3 months.". I had no clue what he was referring to - Ask us? Ask who? I was young and naive and was really clueless to patient empowerment. I didn't ask a lot of questions because I was scared.

I went home that night and searched for ASCUS on the internet. There wasn't a lot of information that I could relate to or even understand. Of course, this was many, many years ago. Today, there is much more patient friendly information about Pap smear results. If you have had an ASCUS Pap result, ask questions. Ask your gynecologist ANY question you have - that is what they are there for! Secondly, if you think of any questions after your appointment, call your doctor and leave a message. Finally, become a more informed patient. You can start by reading this article on ASCUS Pap smear results and why you really shouldn't worry too much over them.

An FDA advisory committee has recommended the use of of Gardasil in males, ages 9-26. Gardasil is currently approved for use in females ages 9-26 to prevent four strains of the human papillomavirus known to cause cancer and genital warts. It is expected to soon gain official FDA approval and be available to young boys and men. No word on whether the CDC will make it a mandatory vaccine. Some people are left wondering why males even need the vaccine if it prevents cervical cancer in women. What many do not realize is that HPV is also linked to other types of cancer like penile and anal cancer in men. We can't forget HPV's role in the development of genital warts, too. While genital warts really don't pose any great health danger in most cases, they are growths that do require medical treatment for removal. Plus, having males vaccinated will reduce the spreading of HPV among both men and women, which will hopefully reduce HPV related diseases.

An FDA advisory panel has recommended the approval of a new HPV vaccine, Cervarix. Obviously a rival to Merck's Gardasil, Cervarix has been approved in Europe for just about as long as Gardasil has in the states. The hold-up on U.S. approval? The FDA was concerned about potential side effects. The vaccine has been given the "all clear" and is expected to be approved by the FDA as early as next week. What does this mean for you?

You now have a choice, that is if you have not already been vaccinated. Is one more effective than the other? No one knows as no studies exist comparing the two. However, both have shown to be highly effective against preventing strains of HPV known to cause cervical cancer, genital warts, and other HPV associated conditions in women. Both vaccines require a series of three shots given over a course of six month. Whichever you choose, you will be getting an effective vaccine that will provide excellent protection against HPV.

I am curious about the cost of Cervarix. Not much has been mentioned about the price point of the vaccine and how it will compare to Gardasil's $300 plus price tag. Considering Cervarix is being approved late in the game, it is interesting to speculate how GlaxoSmithKline (the vaccine manufacturer) will win over medical consumers despite Merck's massive marketing budget and three year head start.