Demystifying the Pap Smear: What New Pap Recommendations Mean for You

Importance of Pap Smears

Since the advent of pap tests, exams that collect samples from the vagina in order to look for foreign DNA, in 1948 doctors have made drastic strides in the detection of cervical cancer, which is the second most common cancer among women worldwide with almost 3,700 American deaths per year. These pap screenings and tests have been shown to reduce the incidence of cervical cancer by 70%.

Pap smears are crucial in the detection of a sexually transmitted virus known as Human Papilloma Virus or HPV which we now know can cause cervical cancer. For most women the virus is transient- the body’s immune system fights off or suppresses the HPV virus before it causes problems and no long term consequences are experienced. An estimated 80% of all women and 50% of men and women combined will get one or more types of “genital” HPV at some point in their lives. However, for some women, the virus becomes persistent causing abnormal cell changes on the cervix, especially for smokers. These changes can develop into cervical cancer if they are not detected and treated early.

New ACOG Recommendations

Recently some new guidelines for Pap Smears and Cancer Screening issued by ACOG (American College of Obstetricians and Gynecologists) have been released in order to encourage more effective pap test screening.  These revised recommendations are:

  • Age of first pap test changed to 21, regardless of onset of sexual activity
  • Women in their 20’s with normal results should get a pap test every other year instead of annually
  • Women over the age of 30 with three normal results should have a pap test every three years instead of annually
  • Women with certain risk factors (conditions like HIV and cervical cancer) may need more frequent screening

Concerns About the New Pap Smear Guidelines

The driving force behind these changes was the numerous clinical studies that show women who are treated for cervical dysplasias are more likely to have a preterm birth. As many as one in 18 women who have had a LEEP procedure, used to remove precancerous tissue often caused by an infection with HPV, will give birth prematurely.

However, there is growing concern among gynecologists that women who read these new guidelines may assume-incorrectly-that if they only need a pap smear every two or three years then they only need to see their gynecologist every two to three years. This is incorrect! Gynecologists provide a range of important examinations aside from pap tests including routine physicals, breast exams, and sexually transmitted infection testing. Women who only need to receive a pap test every other year should still visit their gynecologists for regular check-ups and physicals.

If you have questions about the number of pap tests in your medical history or want more information you should call your doctor and discuss which options are best for you.

You can read more about the revised ACOG Pap Smear and Cancer Screening Guidelines here: http://www.acog.org/acog_districts/dist_notice.cfm?recno=13&bulletin=3161.

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