How Often Do You REALLY Need a Pap Smear?

Once again the media is riddled with news reports about changing guidelines for screening tests for women. Our office phones have been ringing off the hook with questions about new recommendations for frequency of pap smears and HPV testing. Read on to find out the real truth and be accurately informed about what you need and how often you need it.

On March 15, 2012, the American Society for Colposcopy and Cervical Pathology (ASCCP) presented new recommendations for cervical cancer screening. These guidelines are based on reviews of current scientific evidence and are supported by similar recommendations also put out in March by the U.S. Preventive Services Task Force (USPSTF). The recommendations are for reduced frequency of Pap smears and testing for HPV and are based on the fact that cervical cancer is typically slow growing and is usually found in women who have not undergone routine screening for several years.

The most important thing for women to realize is that more time between Pap smears DOES NOT mean more time between check-ups. The Pap smear is only a small component of your annual exam. Your annual visit is still extremely important to ensure that you have a clinical breast exam, a pelvic exam to assess the skin and the internal organs, and to discuss your menstrual cycles, your hormones, and any other concerns you may have with your Gynecologist. The following recommendations sum up the new guidelines:

1. Women under the age of 21 do not need a pap smear regardless of sexual activity.

2. From ages 21-29 women should be screened every 3 years with a Pap smear as long as the results are normal.

3. From ages 30-65 women should be screened with co-testing (Pap smear plus HPV testing) every 5 years or with a Pap smear alone every 3 years.

4. Women 65 years of age and older, without any significant abnormal findings in the 20 years prior (ie. moderate precancerous cells or greater), no longer need pap smears; nor do women who have undergone hysterectomy with removal of the cervix who have not had a significant abnormality in the past.

Keep in mind that women with certain risk factors including, but not limited to, a history of abnormal pap smears, DES exposure, or immune compromise, will have their screening more frequently and as determined by their physician.

While many readers may be outraged that the trend of healthcare seems to be “taking away” more and more tools to ensure our health and safety, let me assure you that these guidelines have been scrutinized by leaders in our field and are felt not only to be reasonable, but actually beneficial for women. Annual cervical cancer screening for all women can lead to many unnecessary procedures including biopsies and surgeries which may impact on a woman’s fertility and create unwarranted anxiety. HPV infections and precancerous lesions in the cervix are extremely common, but most of them are transient and resolve within 1-2 years without any treatment.

So ladies, get your check-ups every year! But be glad you may not need that extra test quite so often!

Dr. Randye Karmin is a Board Certified Ob/Gyn in private practice located in the Dadeland Medical Building at 7400 N. Kendall Drive, Suite 404, Miami, Florida. 305-670-0010.

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