Pap Smear Guidlines Get a Makeunder

Pap tests have long been part of yearly well-woman exams, the idea being to catch abnormalities prevent and treat cervical cancer in its earliest stages.  Traditionally, testing is recommended for women 21 and older or 3 years since becoming sexually active.

New guidelines published earlier this month suggest that these annual exams are excessive, and should only be conducted beginning at age 21, and then every 3 years provided that results are normal.

Reasons cited for the changes include the rarity of cervical cancer in young women and the slow growth rate of the disease.  Additionally, the Pap test can produce false positive results, resulting in unnecessary procedures.  Repeated follow-up procedures can damage the cervix and cause complicated pregnancies.

Additionally, the guidelines outline that at 30, women should be tested for HPV, the hot social disease that everyone is talking about that ALSO causes cervical cancer.  If both tests are negative, there is no need to be tested for either for five years.  The new deal also advises that screenings are no longer needed when woman reaches 65.

In 2008 at 27, a pap smear revealed I had high grade cervical dysplasia.  Three lesions were removed with the LEEP Cone procedure , and my test results have since been clear.  I was not diagnosed with HPV at that time, but it was likely the culprit (it is possible it was not one of the strains tested for– there are about 40 known).   Had it indeed been HPV-related, the great majority of those infections clear themselves,  so I do wonder if such aggressive treatment was overkill.

According to the CDC At least 50% of sexually active people will have genital HPV at some time in their lives. The most common HPV-associated cancer is cervical cancer and almost exclusively the cause.  Studies have shown that 70% of new HPV infections clear within one year, as many as 91% clear within two years. The median duration of new infections is typically eight months.

How do you feel about these guidelines?  Is the less is more approach beneficial or a thinly-veiled money saving tactic?

Comments

  1. There’s also people who have come out against colorectal cancer being over diagnosed.

    I definitely see both sides. They’re both trying to prevent harm to individuals, I think, it’s just a matter of which way is better. Overdiagnosing and putting people through expensive procedures that are hard on their body and potentially their wallet, versus catching real problems quickly so that people are spared a worse fate.

    It’s obviously a very difficult issue, and one I don’t feel qualified to take sides on yet.

  2. I had a low-grade dysplasia about 15 years ago. My doctor made me come into the office to give me the big bad news that my Pap was abnormal and I walked out in tears, imagining my funeral. Seriously, she made me feel like it was such a huge scary deal. Anyway, I had a colposcopy (NASTY) and based on whatever they found (can’t remember, too long ago) they gave me a choice between doing the LEEP thing or waiting six months to see if it went away. I waited; it went away.

    Nearly 15 years of normal Paps later, the last one came back with a low-grade abnormality and I’m supposed to go for another colposcopy. I’ve been stalling for a couple months because – well really, do I have to say why? Because I DON’T WANNA.

    I really had no idea that 91% of these infections clear within two years, though. Thanks for that statistic! I’m thinking to just get another Pap in six months and see if it’s normal then. Don’t worry, Sarah – if I end up with cancer I won’t blame you for enabling my slacking.

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