updated 10/15/2003 6:04:17 PM ET 2003-10-15T22:04:17

An increasing number of women will no longer need annual testing for cervical cancer, say guidelines issued Thursday — the third such advice to doctors in the last year.

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The American College of Obstetricians and Gynecologists said:

A first Pap test should occur within three years after first sexual intercourse or by age 21, whichever comes first. Previously, women were supposed to be tested by age 18 or onset of sexual activity.

Women should undergo annual Pap tests up to age 30.

Those 30 and older have two options. They can start getting checked every two to three years after having three consecutive, normal Pap tests. Or they undergo a combination of a Pap exam and testing for the human papillomavirus, or HPV, that causes most cervical cancer. Passing both those tests means they need rechecking no more than every three years.

There are numerous strains of the HPV virus. Most clear up on their own, but a few types linger to cause cancer. HPV testing isn’t appropriate for women under 30, because younger women often test positive for the harmless, transient strains, ACOG stressed.

Some women may need more frequent exams, such as those with weak immune systems or previous cervical cancer, ACOG cautioned.

The advice largely mirrors earlier recommendations from the American Cancer Society and the government.

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