The cervix is just one small organ on a woman’s body. It is the passage way for childbirth. Keeping your cervix healthy can prevent many long-term problems and help keep you out of the doctor’s office.
Back in the early 1900’s, Dr. Papanicolaou changed women’s health care indefinitely. He instituted a screening test to help lower the incidence of cervical cancer worldwide: The Pap Smear. Cervical cancer affects over 12 thousand women worldwide annually and causes over 4 thousand deaths. This screening test immediately became an integral part of our annual well women’s visit. The question that has arisen over the last 20-30 years is not the validity of the test but the necessary frequency of the test.
Since this discovery women have been making a conscious effort to visit the OBGYN for ‘their annual pap’. Prior they may have seen the OB for pregnancy, irregular bleeding, contraceptive counseling, abdominal pain, abnormal discharge or menopausal symptoms. If none of these issues were concerning then a visit to the GYN was nonexistent. The pap made the annual visit necessary, fashionable and more importantly made women aware of all the other issues in women’s health. We as OBGYN’s have the opportunity to encourage mammograms, colonoscopies, bone health, exercise, nutrition, family planning, contraceptive options, STD prevention, emotional support and therapy and referrals to other health care specialists who can help improve women’s health and quality of life.
In 2003, our awareness of the relationship between HPV (Human Papilloma Virus) and pap smear abnormalities became more evident and we now incorporate HPV screening with the pap smear for a more comprehensive understanding of cervical cancer risk factors. In 2008 the Nobel prize in Physiology or Medicine was given to Harald zur Hausen for his discovery of “human papilloma viruses causing cervical cancer”
We know that most of cervical cancer is caused by high-risk types of HPV. We now do co-testing which includes a pap smear with HPV screening routinely for all women over 30 years old.
Now to review the screening plan:
- Begin screening for all women at age 21, not before.
- Between the ages of 21-30 we perform a pap every 3 year.
- Ages 30-65: Pap every 3 years or co-testing every 5 years. (Pap with HPV)
- If age 65 or you had a hysterectomy removing the cervix you can stop testing.
- If you are HPV positive then repeat your pap in 1 year.
- If your pap is abnormal then you need further testing: a colposcopy.
Beware: Shorter testing intervals may lead to the detection of many more clinically insignificant transient HPV infections, which results in many more colposcopies and potential procedures, with negligible additional reduction in cancer risk.
In 2006, the Food and Drug Administration approved a vaccine against the human papilloma virus. The vaccine prevents most cervical cancers and genital warts. It is a simple 3 shot series you can get with any health care provider especially your child’s pediatrician or your OBGYN (a pelvic exam is not required). It is recommended to children ages 9-26, preferably prior to sexual activity. It is very safe, very effective and can PREVENT CANCER!
You can find information on the web about pap smears, cervical cancer and prevention. Please do your research and take advice from your physicians or health care provider. My last bit of advice for prevention of cervical issues is “don’t trust anyone, use a condom and please stop smoking”, these 2 are the leading causes of getting and worsening cervical cancer and simple things to do to prevent cancer.