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Tougher tests for Pap smear lab readers?

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The feds want the folks who read Pap smear results that check for cervical cancer to take a more rigorous proficiency exam.

A proposal by the Centers for Medicare & Medicaid Services (CMS) would require pathologists and cytologists taking the proficiency exam to read 20 instead of 10 slides of cells. But it would also allow them to take the exam once every two years instead of annually.

Poor analyses of Pap smears in the late 1980s that led to women dying of cervical cancer prompted Congress to pass the Clinical Laboratory Improvements Amendments of 1988, which requires CMS to establish minimum quality standards for lab testing in the U.S. But the testing requirement for Pap smear readers wasn’t implemented on a nationwide basis until 2005.

Since then, pathologists and cytologists have apparently gotten better at reading the smears, with 33 percent failing the test in 2005 compared with 11 percent in 2007, according to CMS. Still, the agency says that's not good enough, especially since the death rate for minority women is falling slower than for white women. There were an estimated 11,070 cervical cancer diagnoses in the U.S. last year and 3,870 deaths, according to the National Cancer Institute.

The proposal is in today's Federal Register. CMS will issue a final ruling after the March 17 deadline to submit comments on the proposal.

Image of Pap smear via WikiMedia Commons