What exactly is a Pap smear, and how frequently do I need one?
Let’s be real. Few women look forward to a Pap smear or pelvic exam.
There is concern about whether it will hurt, and what if they discover something unusual.
As a nurse practitioner, I understand the significance of these tests and why they are required. Both tests have the potential to detect cancer and other diseases before they progress or spread.
There is now some good news for women who dread these appointments. While an annual pelvic exam is still recommended, the most recent guidelines may not require you to have a Pap smear every year.
What exactly is a Pap smear?
To begin with, a Pap smear is not the same thing as a pelvic exam. A pelvic exam is a physical examination of your reproductive organs, both internally and externally. We conduct pelvic exams to look for specific illnesses and to assess the health of your female organs.
A Pap smear is a cervical cancer screening test. We collect cells from outside the cervix and examine them. This test is frequently performed as part of a pelvic exam.
We use a medical instrument called a speculum to perform a Pap smear. Some people call it the duck because it resembles duck bills. Once inserted into the vagina, the speculum allows me to see the cervix.
For most women, the speculum is more uncomfortable than painful, but if you’re nervous, your muscles can tighten, making it even more uncomfortable. If you are concerned about the speculum or any of the other items used during your pelvic exam, speak with your provider.
Once I can see the cervix, I swab the outside of the cervix with a small brush (similar to a mascara brush) to collect cells. This will feel like a gentle tickle or scratch, more uncomfortable than painful. The collection of the cell sample takes only a few minutes.
We’ll put the cell sample in a solution and send it to a lab where it will be examined under a microscope by a pathologist. The pathologist examines the cells for changes that could lead to cervical cancer. Typically, we receive pathologist results within a few days.
How frequently do I need a Pap smear?
The most recent cervical cancer screening guidelines changed the recommendation for when women should have their first Pap smear and how frequently they should have them.
When should I have my first Pap test? Age 21
How frequently do I need a Pap smear?
Women between the ages of 21 and 29: Every three years, following a normal Pap smear.
Women between the ages of 30 and 65: After a normal Pap smear and a normal mammogram every five years
For women over the age of 65 or who have had a hysterectomy for benign reasons, Pap smears are no longer required.
Changes to the guidelines were prompted by new research. Because it takes a long time for cells to go from healthy and normal to really bad, having a Pap smear every year is unnecessary. If your cells are healthy right now, you are unlikely to develop cervical cancer in the next three years. However, you may have some atypical cells by then, which is why we’ll want to screen again just in case.
When I tell them about the new guidelines, most women rejoice. However, you are not entirely blameless. We still recommend a pelvic exam once a year to check for other issues such as ovarian cancer, uterine cancer, or sexually transmitted diseases.
The relationship between cervical cancer and HPV
According to research, nearly every case of cervical cancer is caused by HPV infection. There are over 150 HPV strains, but researchers have identified two types of HPV that are responsible for 70% of all cervical cancer cases. Preteens and teens can now get a vaccine to help prevent the most dangerous strains of HPV.
The vast majority of people have been exposed to HPV at some point in their lives. The virus is usually eliminated by your immune system within a few years, but in some people, the virus persists and damages cells.
Ninety percent of HPV infections occur in women between the ages of 21 and 24. That is why cervical cancer is referred to as “a young woman’s cancer.” It is unique in this regard because, unlike other common cancers such as ovarian cancer and breast cancer, your risk increases with age.
This is reflected in the cervical cancer screening guidelines. When women reach the prime age for HPV exposure, we test them more frequently. When they reach the age of 30, we begin screening for HPV. If your HPV test is negative and your Pap smear is normal, you will not need another test for another five years.
Cervical cancer can be avoided with a Pap smear.
A Pap smear does not screen for all diseases, but it has been shown to reduce your risk of developing cervical cancer. It’s not fun when I’m “down there,” I know, but it only takes a few minutes, and if the results are normal, you’ll have some extra peace of mind.
One of our most serious problems is when women have children but do not return for a Pap test or pelvic exam for 20 years. You’re fine. You’re preoccupied. I understand you’re working. Nonetheless, it is critical to get screened on a regular basis. It may save your life.
If you’re due for a Pap smear or want to learn more about lowering your risk of cervical cancer, make an appointment with one of our OB/GYNs or call 9258116087+7891235003.