Pap smear

You Asked: Should I get a Pap smear every year or every three years?

Every three years is fine, but you should still have a yearly annual exam
August 15, 2016

The annual gynecological exam can be an intimidating doctor’s visit for young women, and it’s easy to feel confused when some doctors say to visit every year, and others tell you an appointment every three years is fine. A Texas A&M College of Medicine OB/GYN believes it’s okay to have your Pap smear (test for cervical cancer) every three years, but you should still come in yearly for your annual exam.

According to the American Cancer Society, cervical cancer rates in women have actually decreased by 50 percent in the last 40 years. This is mostly due to preventive screenings like the Pap smear test. Increased use of the HPV (human papillomavirus) vaccine will be instrumental in lowering the cases of cervical cancer in future years.

“We’ve learned so much about cervical cancer over the past few decades,” said Patricia Sulak, MD, a board certified OB-GYN and professor at the Texas A&M College of Medicine. “The Pap smear is the test we use to find pre-cancer cells in the cervix before cancer develops. It’s an important method to detect precancerous cells or early cervical cancer, when its most curable.”

During the annual exam, a gynecologist will scrape cells from the cervix and send these cell samples to a lab. The lab will then test to see if there are any abnormal precancerous or cancerous cells. The test is called a Pap smear, after the anatomist George Papanicolaou, who developed it.

“Women shouldn’t confuse the Pap smear with their annual exam,” Sulak said. “A Pap smear is part of the annual. In fact, most gynecologists recommend having a Pap smear every three years if their patients’ previous tests were normal.”

“There is nothing magical about yearly exams if none of your tests were abnormal,” Sulak continued. “However, patients can still benefit from seeing their OB-GYN on a yearly basis. This is because sometimes I’m the only doctor a young woman will see, and often I will diagnose other health problems unrelated to the pelvic exam.”

Sulak agrees with the American Congress of Obstetricians and Gynecologists guidelines that Pap smears usually aren’t necessary before the age of 21. Health care providers now know that human papillomavirus is the leading cause of cervical cancer, and the Pap smear test can also test for the presence of HPV if the provider requests that that test also be done.

“What’s interesting is that 90 percent of people infected with HPV will naturally the virus within one two to years,” Sulak explained. “This HPV can cause precancerous cells, but these cells will disappear when the body clears the HPV. If we performed Pap smears on the majority of young girls before the age of 21, we would find pre-cancerous cells and possibly put them through unnecessary procedures, biopsies, and treatments for the condition, when in fact, we could actually damage their cervix because they will clear the virus on their own.”

Still, if you’re having any abnormal symptoms down there, or symptoms of HPV (itching in the genital area or genital warts), you should always contact your health care provider to get tested. HPV is so common that it is estimated that almost half of all sexually active men and women will contract it at some point in their lives; and most people will never know they have been infected, unknowingly passing it to their partners.

“The most aggressive strains of HPV that account for almost 70 percent of HPV-related cancers can be prevented by vaccination,” Sulak said. “This vaccine should always be part of your preventive measures in addition to the Pap smear.”

Important to know: Discussions about whether a yearly or every-three-year Pap smear works for you should be run by your primary care physician. They will have the best knowledge of your health care history and can ensure you make the best decisions for your individual health.

 

— Lauren Thompson

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