Guidelines largely agree on cervical cancer screening: U.S. Preventive Services Task Force issues evidence-based guidelines. (Similar to those of ACS).

Now that the U.S. Preventive Services Task Force has issued cervical cancer screening guidelines similar to those issued recently by the American Cancer Society, experts say that having the two sets of recommendations may lend more weight to what they say.

Although there are some differences between the guidelines, "I think the ACS and we would agree that we're dealing with pretty fine distinctions here," said Dr. Al Berg, chair of the task force and professor and chair of family medicine at the University of Washington, Seattle.

Like the ACS guidelines, the task force guidelines recommend that women start getting screened for cervical cancer a few years after they begin having sexual intercourse, as opposed to immediately afterward.

"We now know that it takes several years for significant cervical neoplasia to occur," said Dr. Kenneth Noller, professor and chair of ob.gyn. at Tufts-New England Medical Center, Boston. But "that doesn't mean you shouldn't be examined [at all in the meantime], because you can get sexually transmitted diseases, or need contraceptives."

For women who have never had intercourse, the task force guidelines--like the ACS guidelines-recommend screening beginning at age 21. But some physicians may wonder why women who have never had sexual intercourse need to be examined at all, said Dr. Nailer, who was not on the task force but has served on several committees dealing with related issues at the American College of Obstetricians and Gynecologists.

"Some people don't know or can't talk about childhood sexual experiences--they might have been molested as a child, or they might have a mental deficiency and may not be able to recall things that have happened to them," Dr. Noller said.

That issue can get touchy, noted Dr. Berg. "We try to articulate in the recommendation that we really don't know the value of screening women who've never been sexually active," he said. "We need to be sensitive in addressing this and make sure that the woman is involved in the decision."