Like some of our previous tips of the month, this one is directed toward the female community but it is important for the guys to read also. Pass this information along to the ladies in your life.
Starting in the early 1970's, Pap tests decreased the cervical cancer death rate by 50%. Cervical cancer is the third most common gynecological cancer in the U.S. and second most common worldwide. It is still the number one cause of death from a gynecologic cancer.
The recommendation remains unchanged that all women over 18 have a Pap smear with their annual pelvic exam. The practice guidelines have changed regarding the frequency of Pap smears. Some women will need frequent screening while others will no longer need annual screenings for cervical cancer. There is an association with Pap smears and annual pelvic exams, however an annual pelvic exam is still very much recommended for all women over 21.
Your first Pap test is recommended 3 years after your first episode of sexual intercourse or by 21 years of age. Women up to 30 should have annual Pap testing because this age group has a higher likelihood of acquiring high-risk HPV which could turn into precancerous cervical lesions. Women 30 and older have an option of two acceptable screening methods both of which may not require an annual Pap test.
- If you have had negative results on three consecutive annual Pap smears. You may discuss with your health care provider, the option of having a Pap test every two to three years.
- The combination of having a Pap test with an FDA approved test for high-risk HPV. If your results are negative on both tests discuss with your health care provider the option of having the combination test every three years. If only one of theses test results is negative, more frequent screenings will be needed.
Guidelines have exceptions and it is imperative that the following women continue with annual screening: women infected with HIV, immunosuppressed women, women exposed to DES in utero, or women previously diagnosed with cervical cancer.
Women who have had a hysterectomy with removal of the cervix due to a non-cancerous condition and have no history of abnormal cell growth should discuss with their health care provider the option of discontinue Pap testing. Women who have had a hysterectomy and have had a history of abnormal cell growth should continue screening until they have had three consecutive negative tests.
It is imperative that you discuss with your health care provider the changes in the use of these screening techniques.
It is still highly recommended, regardless of the frequency of cervical cancer screenings that you continue with your annual gynecologic exams including pelvic examinations.
Please see the October 2006 tip of the month regarding the Gardasil vaccine which is targeted for HPV.
The above recommendations are based upon the American College of Obstetricians and Gynecologists guidelines.
Have a safe and healthy May.