• How Often Do I Need a Pap Smear?

    on Jun 13th, 2017

How Often Do I Need a Pap Smear?

A Pap smear is a screening test for pre-cancerous and cancerous changes of the cervix, which is the tissue at the base of the uterus, located at the top of the vagina.  It is obtained by placing an instrument (speculum) in the vagina which allows visualization of the cervix, and swabbing the cervix with a small spatula-like device.  It is performed on a scheduled basis when you visit the gynecologist for a well woman exam.

In the past, pap smears were routinely done yearly, but with recent information regarding the development of cervical cancer, we now know they can be performed much less frequently.  Over the last 20 years researchers have determined the cause of cervical cancer is due to a serious, persistent HPV (Human Papilloma Virus) infection of the cervix.  HPV is a sexually transmitted virus which is easily transferred between partners but causes no symptoms.  In over 90% of cases, the infection spontaneously resolves so that the virus causes no long-term harm to the cervix.  If the virus is not adequately dealt with by the immune system, a persistent infection may result which, over years, can develop into a pre-cancerous change on the cervix (dysplasia) or even cancer.

Because HPV is quite prevalent, many newly sexually active women may get an infection and not know it as it causes no symptoms in either partner.  Fortunately most of these infections spontaneously resolve without any treatment.  For this reason, we no longer perform pap smears on women < 21 years of age (except under special circumstances).  Gonorrhea and Chlamydia (STI) screening is always performed annually, however, as these infections could lead to serious problems in the future.

Once a woman turns 21 we start performing pap smears.  If it is normal, we repeat it in 3 years.  If it is not normal, other studies may be recommended depending on the problem.

When a woman turns 30 we start screening for HPV along with the Pap smear (called “Co-testing”), as by this time an infection may be a more severe, persistent infection.  If the Pap smear is normal and the HPV testing is negative, the Pap smear can be deferred for 5 years (one should still come in for annual well women exams for other reasons).  If the Pap smear is normal but the HPV test is positive, a repeat pap smear is recommended in one year to see if the HPV infection has cleared.  If it has not, or if the Pap smear is not normal, colposcopy (examination of the cervix, vagina and vulva with a magnifying telescope) is recommended.  If a woman over 65 has had no abnormalities of her Pap smear all her life and is in a mutually monogamous relationship (no new HPV exposures), she no longer needs Pap smears.  Finally, if a woman has had a complete hysterectomy (cervix removed with the uterus) and she has never had an abnormal Pap smear, she no longer needs Paps.

Thanks to regular screening with Pap smears, the incidence of cervical cancer in this country has decreased by 50% over the last few decades.  The Pap smear is one of the best cancer screening tools available - relatively inexpensive, fast and not too uncomfortable.  If you have not had your Pap smear, please make an appointment so we can take care of that for you.  Call us at 714-378-5606.

For more information go to:  http://www.acog.org/Patients/FAQs/Cervical-Cancer-Screening-Infographic and http://www.acog.org/Patients/FAQs/Cervical-Cancer-Screening

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The Women's Health Center
9940 Talbert Avenue, Suite 303
Fountain Valley, CA 92708
Phone: 714-462-1348
Fax: 714-378-5621
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