By: Marta Staple, APNP
Have you noticed that your doctor or health care provider has stopped saying the word “annual” before the words “pap smear?” Big changes in pap smear screening have occurred in the last 2 years, and the change is from annual pap smears to pap smears every three to five years.
For those of us who have grown accustomed to the pap smear as an expected part of the annual health maintenance exam, it can be a confusing change. Conversely, many women dislike this portion of their annual physical exam and are happy to have fewer pap smears in their lifetime. Both of these reactions to the change are common. Knowing what is right for your health arises from a good understanding of the change in screening recommendations and a conversation with your healthcare provider about how these guidelines apply to you as an individual.
A pap smear is a screening test for cervical cancer, which is a common disease for women worldwide and a leading cause of death for women worldwide. Cervical cancer is caused by small group of high risk types of Human Papilloma Virus (HPV), which is a sexually transmitted disease. In the past, pap smears were recommended to begin within 3 years of the onset of sexual activity, and pap smears would continue annually until age 65 or 70.This pap smear screening schedule reduced the frequency of cervical cancer by 50% in the last 30 years.
New research data shows that a pap smear done every 3 years for women between the ages of 21 and 30 (regardless of onset of sexual activity), and every 5 years with additional high risk HPV testing in women over the age of 30 is as effective as yearly screening to reduce the rate of cancer deaths, but has the additional benefit of reducing the harm of false positive tests. False positive pap smears lead to unnecessary biopsy and treatment procedures that can cause problems in pregnancy later, like preterm labor and low-birth-weight infants. Less frequent pap smears lead to fewer health risks, but it maintains the same degree of disease protection.
A growing number of young women have been vaccinated against HPV infection through the Gardisil vaccine. This vaccine has been shown to reduce the rate of HPV infection in the vaccinated recipients. It protects against 2 types of high risk HPV infection, but it does not protect against all forms of high risk HPV infection. This means that women who have been vaccinated are still at risk for cervical cancer. The new pap smear screening guidelines apply to these women.
Of course, there are still circumstances when a pap smear is recommended more often than every 3-5 years, and those circumstances include a history of moderate or severe cervical dysplasia or pre-cancerous changes, HIV or other forms of immune compromise, unexplained abnormal pap smears, or unusual symptoms.
If you feel confused about these new recommendations, talk with your healthcare provider, who can help you create a comfortable plan for screening that is right for you.
For more information on preventing cervical cancer, watch Marta’s WKOW interview that aired on January 11.