Pap Test by Evelyn Felluca, MD FACOG
Cervical Cancer Screening, known as the pap smear or the “dreaded” pap test, until recently, was commonly performed at every gynecological annual exam.
WHAT is a Pap Smear Test?
A Pap Smear samples cells taken from the cervix, the mouth of the uterus, which is at the top of the vagina. This is a screening test to look for Cervical Cancer.
HOW do you take a Pap Test?
During an office visit, a plastic or metal device, called a speculum, placed in the vagina, allows the cervix to be seen. Your provider uses a plastic swab or brush to collect cells from the cervix. A lab evaluates the cells for possible abnormal cells.
Oprah called speculums “shoe horns”- I promise that I have none of these in my closet!
WHEN do I have to do a Pap?
With the addition of testing for high risk HPV types with your pap smear, the accuracy, due to more predictable results, in detecting cancers earlier is better. This means annual pap smears are not necessary in low risk patients.
I’m commonly asked, “If you’re not doing the pap test, why am I here?” Great question!
However, an annual exam is a yearly health and preventive medicine exam catered to you. The cervix is not the only part of your body that needs to be examined annually. Depending on your age, health and risk factors, different potential health problems need to be discussed with your provider. Education and testing for problems before they arise may help prevent them, or at a minimum, identify them early, resulting in better health.
New guidelines recommend the following:
- Start pap smears at 21
- Start High risk HPV testing at 30
- Low risk individuals should have pap smear testing between 3-5 years.
- No pap smears for low risk individuals after 65.
- No pap smears for patients with total hysterectomies, meaning cervix removal at the time of the hysterectomy, for benign (without cancer) reasons.
WHAT IF I have an Abnormal Pap Smear, does that mean I have Cancer?
Absolutely not! Take a deep breath! A pap smear is a screening tool.
If it’s a little abnormal, it tells us to either repeat it in a year or move forward with a colposcopy.
Colposcopy, a minor office procedure, magnifies the cervix to help see the abnormal areas for biopsies. A lab analyzes these samples for possible cancer.
Depending on the result, either repeat the pap smear in 1 year or discuss any further treatment options with the doctor.
A Common Misconception:
I had the HPV vaccine, why do I now have HPV or an abnormal pap?
There are over 100 HPV types.
Gardisil 4 was the first HPV vaccine which protected against the top 4 most common HPV types that cause 75% of Cervical Cancers.,
Gardisil 9 is the second generation HPV vaccine that protects against the top 9 most common and most aggressive HPV types, giving protection against 90% of HPV types that cause Cervical Cancer. In cases of previous exposure, the vaccine will not work.
CAN I get the Gardisil 9, if I had the Gardisil 4 Before? YES
Risk Factors that Increase Cervical Cancer Risk
- Sex at any early age
- Multiple sexual partners
- Unprotected sex, without condoms
- Sex with high risk individuals
- More common in women 50 years old or younger
Remember: Safe sex is the best protection
For more information, please see our Health Library
Additional information can be found at ACOG FAQ’s
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