In the office and around town we are hearing a lot about breast cancer and getting your annual mammogram. I even wrote a post about my experience a couple of weeks ago. I then began to think it strange that we talk openly about mammograms, but no one bothers to mention that other fun annual experience… the Pap smear.
Yes, it is less fun than the mammogram but it can prove to be as important. For those that have never asked, the Pap smear is a screening for changes in the cervix cells. More specifically it is to screen for cervical cancer — the third most common form of cancer in women. Cervical cancer also is known as a silent killer among oncologists, due to its lack of symptoms in the early stages. I know this because I nearly became one of its victims.
At the age of 22 I was getting regular annual Pap smears. However I moved away to attend college and delayed my screenings. When I got around to finding a doctor and getting my annual exam, the screening showed abnormal cells. The doctor proclaimed it was nothing to worry about. However, being the daughter of a nurse, I wasn’t comfortable with that answer. So I picked another doctor for a second opinion.
Three weeks later I was in the hospital having a portion of my cervix removed due to pre-cancerous cells or dysplasia. Thankfully that was more than 25 years ago, but the fear has stayed with me. Therefore, I feel it is my duty to wave this banner and share some expert advice from Dr. Matthew Voth, an obstetrician/gynecologist with Via Christi Clinic:
When should I get a Pap smear?
Current recommendations, released in 2009, say a woman should have her first Pap smear at age 21. This differs from the previous recommendation of “within three years of her first sexual encounter, or age 21,” whichever came first.
The reasoning is three-fold:
- We used to think HPV (the virus responsible for abnormal Pap smears) was a lifelong illness and needed to be addressed as close to initial exposure as possible. It is now known that a young woman (i.e., less than 21 years of age) can eradicate the virus with her own immune system.
- When a woman receives a Pap result of “high grade,” a procedure is indicated that removes a portion of the cervix. This procedure can result in preterm labor in subsequent pregnancies.
- It is now clear that even high grade lesions rarely result in cancer in women less than 21 years of age. Therefore, a woman’s initial Pap smear should occur at age 21. The only exceptions to this include women who might be immunosuppressed, such as transplant patients, or patients with HIV.
Other screening recommendations:
- Women between ages 21 and 30 need a Pap smear test every 2 years (considering no high grade lesion is found).
- After 30, a woman can go every 3 years between Paps (considering three consecutive normal Paps prior to age 30).
- If a woman has had a total hysterectomy (cervix removed), she does not need any further Pap tests (if she has had no history of a high grade lesion).
- It is OK to stop all Pap smears at age 65-70 in women who have a 10-year history of no high grade lesions, and three consecutive normal Paps.
Confusing? I know! Please discuss this with your doctor. Chances are you could actually be getting unnecessary Pap smears.
Keep in mind: You do need an annual breast exam and a physical every year.