10/21/2012 9:30 pm
The American Cancer Society, The American Society of Colposcopists and the American Society of Clinical Pathologists have updated guidelines!! These groups have met and carefully considered new guidelines for pap test screening. The bottom line is that the pap is a very good test for cancer screening. It is so good, in fact, that we do not need to do the pap test every year on most patients. If you have a history of abnormal pap tests, then we should continue annual or every 6 month screening. It turns out that most women diagnosed with cervical cancer now have not been seen at all for pap tests!
The American College of Obstetricians and Gynecologist published a patient fact sheet supporting this news in 2013 at the following link: New Guidelines for Cervical Cancer Screening
What if you have always had normal pap tests? Or at least the last 5 years? Well we have the option of spacing out the pap test to every 3 years in women aged 21 to 65. In women aged 30 to 65, if you want to do an HPV (human papillomavirus) co-testing, we can space this out to every 5 years if both the pap test and the HPV test are negative. We are not recommended to do the pap at all in women under 21 or over 65. The expense and discomfort of the evaluation are not likely to be worth the benefit in the vast majority of these patients.
Patients who have had a hysterectomy have been asking me for years why they had to keep coming in for the pap test. Since these new guidelines have been published, I can now answer this question with more conviction. No more vaginal pap tests for women with a hysterectomy for benign disease. This is because vaginal cancer is so rare. If your hysterectomy was for cancer, then we still should continue the pap test.
Does this mean you don't need to come see the gynecologist? ACOG (their link is in Health Education page on this website) is my favorite source of reliable material and their committee on this subject said that you still need an "annual well women visit" even if you are not due for a pap test. We are thinking this is a good time to just think preventively about your health. This year we are still even doing the speculum exam on most of our patients until we hear otherwise. You can opt to do this annual visit with your primary care provider and just see us for gynecologic problems as needed.
Call or portal message us if you have questions about this. It is not wrong to continue the paps every year if this change makes you nervous. This is not an insurance coverage issue, it is just an attempt to help decrease the ever-spiraling cost of health care.