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Wednesday, August 27, 2014

Who Should You Ask About When To Get Your Next Pap Smear?

Cervical cancer detection is more than just a pap smear, it's getting regular pelvic examinations, following up episodes of bleeding or pain, and having a personal gyno to consult regarding how to lower your cancer risks. But, ultimately, most do rely on regular pap smear testing to determine their risk for cervical cancer. Pap smears are a sampling of the cervical cells to determine whether the cells are normal. As such pap tests don't treat cancer, they seek it, as in a simple screening test. Pap smear testing cannot detect all cancer, just most of it, yet who to test, and exactly how to test has been under debate as we try to further eliminate cervical cancer, but focus on safety and cost for American women. Many organizations have produced pap smear guidelines. American Cancer Society recommendations can be found at this link  .The American Society for Colposcopy and Cervical Pathology can be found at this link, where they discuss the guidelines that were put in place in 2012. Gynecologic Cancer Foundation.  Under age 21: You probably don't yet need a pap. Under age 30: Get a regular pap ever 3 years, keep getting pelvic exams, and some physicians believe in beginning HPV testing over the age of 25. Over age thirty? Add a HPV test to your pap, or alternatively begin with an HPV test. Previous abnormal pap smears will change what your gyno recommends for pap test screening? You may have recurrence risk for over 20 years. We have told women that they need yearly pap smears for so many years that even though it's been a recommendation since 2003 to do fewer pap smears gynos often sticking to the every year pap. And you and your gyno know more about your risks, and the absolute costs and potential for harm the test would have in your case. Drs. Chelmow, Waxman, Cain and Lawrence writing a commentary on this topic in Obstetrics and Gynecology in April of 2012 have said that the 'yearly' plan was 'chosen arbitrarily.' It's hard for gynos to switch gears, and we didn't embrace the every other or every third year smears as a group. Now again we have  extended the overall interval that pap smears are necessary, and it's all based on your age, and the next factor is your history of cervical disease and HPV disease. We know that Gardasil vaccination will affect this as well, but currently whether you have been vaccinated against HPV disease doesn't change when we recommend pap smear testing. Very specific factors in your case have to be discussed with your individual gyno. She may not have even had time to digest all the technical information in these guidelines. They are published on line for those who are interested in the details.
The NIH expresses their views on cervical cancer screening at the
New Pap Testing Recommendations March 2012 And the newest information, now that the health care law has gone into effect: Plans must cover HPV testing! So for women over the age of 30, even with a normal pap test, if you haven't had HPV testing, it is now covered by most plans, and will be covered by all plans with in the year. For more specific information regarding what the Affordable Health Care Act covers for women check their website.

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