The Tests Women Really Need [part2]

Breast Self-Exams
These are fast and free, and the USPSTF's recommendation against teaching them has caused a big-time brouhaha. The group argues that self-exams have not been proved to reduce cancer-related deaths, though no conclusive study has been done in the United States. Most doctors say not to quit altogether. "Women often discover their own cancers," says Runowicz . "So if you're not going to panic about every lump — and if you're young and menstruating, there will be lumps — there's little downside to doing self-exams."

Most lumps in younger women are caused by benign cysts, but there are no absolutes. "I've evaluated women as young as 22 who were diagnosed with breast cancer and found the abnormality while doing a breast self-exam," says Sandhya Pruthi, M.D., director of the breast clinic at the Mayo Clinic Cancer Center. "If we'd told them 'Don't touch your breasts,' a lump that was cancerous may have been detected at a much later stage."

The bottom line: Become familiar with the normal changes of your breasts by examining them monthly, in the days just after your period. For instructions, visit cancer.org.

Pap Smears
ACOG now says that women should get their first Pap smear, a screener for cervical cancer, at age 21, with follow-up tests every other year until they turn 30; women over 30 who have had three consecutive "normal" results can then wait three years between tests. The group points to studies showing that only 0.1 percent of cervical cancer cases occur in women under 21, but that does little to ease big fears that the killer disease could grow undetected between spaced-out exams.

The bottom line: "It's all about risk," says Celeste Robb-Nicholson, M.D., associate chief of general medicine at Massachusetts General Hospital. "A healthy woman who is HPV negative and is either not sexually active or has just one partner can be screened every three years. Women who have risk factors — such as smoking and having multiple partners — should be screened annually."