New Pap Smear Guidelines

Tuesday, September 11, 2012 - 10:18am

One thing that I have run across frequently is the surprise of women when they hear that they do not need to repeat a pap smear for 3-5 years!  Many women are shocked to hear this because for most of their adult life it was drilled into their head to come in for their yearly exam and Pap test to screen for cervical cancer.  While this is how it used to be, things have changed as medicine is striving to adopt evidence based guidelines to give the best care possible.  The American Cancer Society, U.S. Preventative Task Force, American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology have all published new screening recommendations that extend testing intervals out to at least three years in average risk women.  The move to adopt screening intervals that are further apart is not new and has been a long time coming.  In fact, this has been in the works since the 1980’s.

There are many good reasons for increasing the time between cervical cancer screenings.  First, cervical cancer is slow growing.  Most women who develop cervical cancer have never had a pap smear in their lives, or have not had one in over five years.  Because the Pap smear test can also pick up cervical changes that will never develop into cancer, screening too often can lead to unnecessary procedures and treatments.  Second, HPV (human papilloma virus) infection rates are high, but most cases resolve on their own.  80% of women will have HPV at some point in their lives.  It is very prevalent virus that can cause cervical changes which often go away on their own, without treatment.  Sometimes treatment can do more harm than good.  Lengthening the cervical cancer screening interval attempts to balance the risks and benefits.

So does this mean you should only visit the gynecologist every three years?

NO.  A yearly well women visit is much more than a pap smear.  A pelvic exam without pap and breast exam are still an important part of women’s health.  Women are also encouraged to come in and discuss things like family planning, STD testing, and menopausal symptom management.  The new recommendations are just that- recommendations.  You and your doctor may decide on a screening plan that is individual to you depending on age and cervical cancer risk factors.  If you would like to know where you fall within the new recommendations please ask your gynecologist today!