Pap Test Guidelines and Annual GYN Exams
You might be one of the millions of women who can stop getting annual Pap tests or at least cut way back. But that doesn’t mean you can do without an annual gynecologic exam. Here’s the scoop:
Based on recommendations from leading medical groups, an annual Pap test is no longer recommended for most women. A Pap test is a screening test for cervical cancer that involves taking some cells from your cervix and examining them under a microscope for any abnormalities.
“When we first started doing Pap tests in the 1950s, we weren’t sure what caused the abnormal cells – we just knew that they were precancerous changes,” explains WHCMA Obstetrician-Gynecologist and Medical Director, Dina Deldon-Saltin, DO. “But the test saves lives by detecting abnormal cells before they turn cancerous or, if cancer has developed, the test finds it early, when there’s the best chance of a cure. For many years it was recommended that all women have the test annually starting at age 18 or when they became sexually active.
“Then, in the 1990s, we discovered that human papilloma virus (HPV) causes nearly 99 percent of cervical cancer,” she continues, noting that the virus is transmitted during sex. “Now we can test for HPV, so if a woman doesn’t have it, it’s no longer necessary for her to have an annual Pap test.”
So how often should women have a Pap test? It depends.
Dr. Deldon-Saltin outlines the new screening recommendations from the American Congress of Obstetricians and Gynecologists (ACOG):
• Screening should start at age 21
• Between age 21 and 30, Pap tests every other year if results remain normal
• For low-risk women over age 30, screening every 3 years if their Pap and HPV tests are normal
• Women 70 and older with normal Pap tests several years prior to age 70 can stop having the test
“But anyone who’s immunocompromised – HIV-positive, for example – or who works in the sex trade still needs annual screening,” Dr. Deldon-Saltin points out. “So does anyone in her twenties who’s had an abnormal Pap test. And anyone over 30 who’s had high-risk cervical dysplasia (a potentially pre-cancerous condition) must have normal tests for 20 years before foregoing an annual Pap test.”
And no woman – however low-risk – should forego an annual doctor visit that includes pelvic and breast exams.
“The Pap test only screens for cervical cancer,” Dr. Deldon-Saltin says, “not sexually transmitted diseases, endometrial and ovarian cancer, or fibroids. “We still need to take a look down below to make sure we don’t see or feel any lumps, bumps or lesions that shouldn’t be there. And we need to perform a breast exam.”
Bottom line, she advises, every woman should see her doctor regularly.
“Based on your history, an annual Pap test may not be necessary,” she says. “But a regular gynecologic exam is still extremely important.”