Did you know the recommendations for cervical cancer screenings have changed? Many of you will remember when you were asked to go in every year for your “Pap smear”. It became so routine that patients were often not sure when they were due for a Pap smear and when they were not. Many came to believe that every time they had a gynecological examination with a speculum they were getting cervical cancer screening done. In recent years, all of that has changed. Now, Pap smears are not even recommended until age 21. Mothers often comment or come in with their daughters concerned that screening should be undertaken at an earlier stage than the recommended age of 21.
We know that cervical cancer is almost universally caused by human papillomavirus (HPV). There are many types of the virus with some tending to cause genital warts while others are more likely to lead to cervical cancer. With the onset of sexual activity, many women develop HPV infections that resolve so quickly that they are not important in terms of cervical cancer development. That is why we now wait until age 21 for cervical cancer screening to avoid excessive diagnosis and treatment of a problem that would have resolved on its own. Additionally, now rather than just having a Pap smear, many women are screened for HPV as well, especially after age 30. If you are found after age 30 to be free of HPV, we have started to stretch the frequency of Pap smear testing out into the future dramatically. With negative HPV testing after age 30, it is not unusual to have followup testing at 3 or even 5 years.
With that in mind, some patients have the perception that they only need to see a gynecologist at very infrequent intervals. Many patients will ask if they are at risk for uterine cancer, ovarian cancer, or other STDs. Very perceptive! The only real change in recommendations for gynecological care is the frequency of the Pap smear and HPV test, and this is only a very small part of ongoing gynecological care. It is very important to see young women below the age of 21 for other screenings, especially if they are sexually active. This is also a golden opportunity for education for these young women prior to directing their own medical care. Additionally, vaccines are available to prevent some of the more dangerous HPV infections and those ideally need to be administered prior to sexual activity. You are welcome to call Premier Women’s Healthcare in Delta for any questions of the general nature prior to considering an office visit with one of our physicians.
– Brian Eades, M.D. Board-Certified Ob-Gyn at Premier Women’s Healthcare of Delta