Cervical cancer is the easiest female cancer to prevent, as we have excellent screening for it and now even a vaccine against the virus that most often causes it. Over the past few years, we have transitioned to new guidelines that change when we start cervical cancer screening pap smears in patients, how often we do them, and have added a test for the human papillomavirus (HPV).
What is a pap smear? As you know, a pap smear is performed in the office by your practitioner and involves taking a sampling of the cells on the surface of the cervix, located in the upper vagina, which is then sent to the pathology lab, where the cells are examined under a microscope for pre-cancerous changes. In conjunction with other factors such as your personal health history, human papillomavirus (HPV) screening, and your age, we can estimate the likelihood that any atypical cells seen will either resolve on their own or will require further intervention/investigation.
What is HPV? Human papillomavirus (HPV) is a virus spread through sexual contact. It is EXTREMELY common (according to the CDC, “about 79 million Americans are currently infected with HPV. About 14 million people become newly infected each year. HPV is so common that most sexually-active men and women will get at least one type of HPV at some point in their lives”) and most often shows no symptoms. There are many strains of it, several of which are culprits in causing cervical cancer (and genital warts, vulvar, vaginal, esophageal and penile cancers). We can screen for several types of HPV with just a vaginal swab, that we take while performing a pap smear. There is also a vaccine series to prevent the most problematic strains of HPV, available for males and females ages 11-26. Ask about it for you and your family!
The major changes in the screening protocol have to do with adding routine HPV testing and at what age we start pap smears and then how often we screen throughout a woman’s lifetime.
It is now recommended that, instead of starting at age 18 or the age of first intercourse, all women start their screening pap smears at age 21. This is because, before age 21 the HPV virus, and any cervical cell changes that it causes, usually resolves on its own, so interventions and screening any earlier than 21 have proven to be unnecessary.
The interval between required pap smears has also changed. For many people, it is no longer necessary to have yearly pap smears. Depending on HPV status, age, and personal history, you may only need to have them done every 3-5 years. This is a case-by-case schedule and you should definitely talk to your practitioner about your unique requirements.
Please read this bulletin or more info: ACOG (American College of Obstetricians and Gynecologists) pap test guidelines.
Remember that, no matter how often you’re having the actual cervical screening, your “annual” should still be done ANNUALLY, as there are other screening tests and conversations that need to happen every year (breast exam, evaluation for uterine and ovarian changes, discussion about pregnancy planning, menstruation concerns, hormones and birth control, general changes in your health, etc).
As always, please speak to your provider about any questions/concerns that are specific to you and your health. Screening schedules will vary patient-to-patient. Please call if you have any questions/concerns.
To your health!