If you’ve been to your women’s health provider recently, you may have been surprised when she did not recommend or perform your annual Pap smear. What’s up?
For more than 50 years, women have heard about the importance of an annual Pap test, the test that screens for problems that may lead to pre-cancer or cancer of the cervix, (the opening to the uterus). But, research in the last 20 years has led to the conclusion that the previous methods for screening and treating may be too aggressive and may cause more problems than they prevent. By studying large numbers of women, and the human papilloma virus (HPV) that causes cervical dysplasia, we have come to understand that although large numbers of women may be exposed to the virus, only a small number will develop problems that require treatment. Most women with a healthy immune system will be able to clear the virus, and reverse its effects on their own without needing treatment.
New and Improved Pap Smear Recommendations
As a result of the good news that women with healthy immune systems won’t need aggressive treatments to respond to HPV, there are new recommendations regarding screening Pap smears. While these changes don’t apply to women that have already had a recent abnormal Pap test, or women that are having problems – such as abnormal bleeding, the new recommendations for women who have been having normal Pap smears for the last several exams have changed.
- Women under age 21: No screening Pap smear recommended; continue testing for STDs if sexually active.
- Women age 21-29: Recommend screening with Pap smear (cytology only) every 3 years.
- Women age 30-65: Recommend screening Pap (cytology only) every 3 years or Pap smear with cytology and HPV co-testing every 5 years.
- Women over age 65: Recommends no further screening if the patient has adequate prior screening and is not at high risk for cervical cancer.
- After hysterectomy: No further screening Pap smears recommended after removal of the uterus and cervix unless the hysterectomy was done for high-grade dysplasia.
Remember women still need to come in for an exam every year! There are many things women’s health care providers are doing to protect a woman’s reproductive health – managing birth control; screening for infections; and watching for conditions like diabetes, high blood pressure, and thyroid problems. Always remember that a doctor’s recommendations about Pap smear schedule is specific to her personal health and well-being.– C. Tony Dunn, MD is a Scott & White OBG practicing out of Waco, Texas. He also serves as an American Congress of Obstetricians and Gynecologists’ (ACOG) Texas District Officer.