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Pap smear

Do you really need a Pap smear?

If you’re not sure when you’re due for a Pap smear, you aren’t alone. Pap smear guidelines have changed over the past few years and keeping track of them can be confusing. 

You may not need to get tested as often as you used to, but Pap smears are still a crucial preventive measure, says Kevin Edmonds, M.D., an obstetrician and gynecologist at Piedmont.

Women should start getting Pap smears at 21, Dr. Edmonds says, and they should continue getting them every three years until they’re 65. If a screening detects abnormalities, a patient may need to get tested more frequently. 

What is a Pap smear?

A Pap smear examines the cells of a woman’s cervix to see if they are healthy. The test emerged from the studies of Dr. George Papanicolaou in the 1930s. 

Pap tests can detect the earliest signs of cervical cancer, the fifth most common cancer worldwide and the eighth most common cancer in American women. Your chances of developing cervical cancer peak in your 30s and again in your 50s.

The importance of screenings

Although new recommendations call for fewer Pap smears across a woman’s lifetime, Dr. Edmonds emphasizes the importance of receiving them. 

“You’re keeping up with your medical screening” by getting a Pap smear, he says. If a woman skips tests, she may be putting herself at risk.

“You could be missing something that could potentially, over a long period of time, be detrimental to your health,” Dr. Edmonds says. 

Shifts in screening guidelines

So why did screening guidelines change? Abnormalities in cervical cells take a while to evolve, and cancers may not develop for a decade or more. In fact, some abnormalities simply disappear on their own. 

“We found out that we were intervening and subsequently, having women undergo unnecessary testing and procedures,” Dr. Edmonds says. 

If your Pap smear results are normal, your chances of developing cancer in the following three years are very low. But precancerous cells may develop in that time, which is why you should get another screening in three years. 

If you do have a Pap smear that shows abnormalities, Dr. Edmonds says, don’t assume the worst.

“An abnormal pap smear doesn’t mean cancer,” he says. The patient may need a follow-up test, which could lead to additional screenings or procedures. 

HPV and cervical cancer

An abnormal smear may be the result of human papillomavirus, or HPV. This virus can cause cervical cancer in women, but it doesn’t show any symptoms, so women should take steps to protect themselves in advance.

The Gardasil vaccine can prevent some HPV strains (including the one that causes pre-cancerous cells and cancer in the cervix). It can also guard against genital warts. Girls as young as 9 can receive the vaccine. 

HPV is extremely common, and approximately eight in 10 women will become infected with it in their lifetimes. Dr. Edmonds recommends that patients receive the Gardasil vaccine and schedule regular pap smears if they’re 21 or older. 

Pap tests and annual well-woman exams

Even though women may need less frequent Pap smears, they still need to visit their gynecologist for annual exams, Dr. Edmonds says. 

A Pap smear is not the same test as a pelvic exam, which can help doctors find abnormalities beyond just the cervix. Additionally, women can discuss birth control, hormone issues and other important topics at their annual exams. 

Dr. Edmonds recommends that women who want to protect themselves use condoms during sex, which reduce the spread of HPV and other sexually transmitted infections.  

Routine exams such as Pap tests can greatly reduce your risk of contracting and dying from cervical cancer, so talk with your doctor about how often you need to be screened. For more information on Pap tests, visit Piedmont Gynecology.

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