The Pap smear is an integral part of your annual gynecological exam.
Cervical cancer was once one of the leading causes of death from cancer
in women. Thanks to the Pap test, the number of women in the US who get
cervical cancer has decreased significantly. Luckily, cervical cancer
can be prevented in most cases by early detection with the Pap.
When and how often do I need a Pap smear?
Both the American Cancer Society (ACS) and the American College of
Obstetricians and Gynecologists (ACOG) guidelines recommend that
cervical cancer screening begin three years after a woman begins having
vaginal intercourse but no later than age 21. ACOG then recommends
annual screening in women younger than 30 years old. Women 30 years of
age and older with three consecutive satisfactory, normal results can
then reduce the frequency of testing to once every three years. It is
important to remember that even though the Pap smear may no longer be
necessary annually, a full gynecological exam including pelvic and
breast exams is warranted every year. Women at higher risk for cervical
cancer, such as those with HIV or are immunosuppressed, should be
screened more often.
How should I prepare for my Pap smear?
Try not to schedule an appointment for a time during your menstrual
period. For 48 hours prior to the test, do not have sexual intercourse,
do not douche, do not use tampons, birth control foams, jellies, or
other vaginal creams or medications.
Pap smear and HPV testing
Recently, the combined use of the Pap smear and Human Papillomavirus
(HPV) testing has been proven to improve our ability to identify those
women who are at risk for the development of cervical cancer or its
precursor lesions. Simply put, the Pap test assesses your present risk,
whereas the HPV test provides a measure of not only present but also
future risk. The combined Pap/HPV testing is currently recommended for
screening only in women 30 years and older. A normal Pap smear and
negative HPV result provides increased reassurance for a screening
interval of every three years. Combined Pap/HPV testing is not
recommended for primary screening in women younger than 30 because of
the high rate of HPV infection, most of which is transient, in this age
group.
What is HPV?
Human Papillomavirus infection is usually harmless and temporary. Most
people with HPV will never know they are infected because the virus
usually goes away on its own. There are many types of this common
virus, but only a few “high risk” types can lead to cervical cancer.
These high risk types are spread through sexual contact. Other “low
risk” types can cause genital warts but do not cause cancer. If these
abnormal cells go undetected, they may become cancer over a long period
of time. However, most cell changes return to normal by themselves.
Who can get HPV?
Anyone who has ever had sex, both men and women, can get an HPV
infection. It is estimated that at least 75% of people will get an HPV
infection during their lifetime. HPV infection is spread by direct skin
to skin contact during vaginal sex. HPV infection is more common in
younger age groups. Because HPV is spread mainly through sex, your
chances of getting it increase with the number of lifetime sexual
partners, starting sex at an early age, and having sex partners who
have or have had many other sex partners.
Can HPV be treated?
There is no treatment or antibiotic available for the virus itself.
However, there are treatment options available for the cervical changes
that HPV can cause. Your doctor will discuss these with you if
necessary. An HPV vaccine is being investigated for future preventative
use.
If I test positive for HPV, when did I get it?
It is usually impossible to know when a person got HPV or from whom.
HPV can be found soon after contact, or not until many years later.
Most men and women do not know that they have the virus. In addition,
condoms do not provide complete protection from HPV. Since the virus is
so common, having only one lifetime sexual partner does not assure
protection. For these reasons, it is not fair to blame your partner or
yourself.
If I have HPV, is there anything I can do?
Yes, don’t smoke. Smoking increases the chance that cell abnormalities
may progress to more severe changes by allowing the virus to linger.
Maintain your health with proper diet and exercise. Make sure to follow
up regularly with your doctor appointments.
Will I always have the HPV virus?
No one knows for sure, but probably not. HPV usually goes away within
one to two years.
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