The US Preventative Services Task Force (USPSTF) has finally caught up with the American College of Obstetricians and Gynecologists. In the past, guidelines recommended annual Pap smears. In 2009, ACOG recommended that Paps be done only every 2 years in low-risk women and every 3 years in women who have tested negative for HPV. I’ve been following those guidelines since 2009. The USPSTF has finally updated their recommendations to reflect the newest evidence. You can read the complete article here.
So, what is a Pap test? A Pap smear (named for Dr. Papanicolau) is a test for cervical cancer. A small brush is used to scrape some cells off the cervix (the tip of the uterus). A pathologist then looks at the cells to determine if any are abnormal. The Pap smear is an incredibly effective screening test for cervical cancer- one of the best screening tests out there. It’s rare to see a woman die of cervical cancer these days, thanks to Pap smears.
However, cervical cancer is slow growing. It first shows up as abnormal cells, then progresses a bit to low grade and high grade lesions in several stages. These lesions often regress on their own, as the body’s immune system fights them. Rarely, a lesion will actually progress to cancer. The problem with yearly Paps is that they catch all these abnormal cells, and that leads to biopsies. These biopsies, if abnormal, might lead to an excision of the area- this can lead to complications. The evidence shows that a time span of 3 years is fine to catch lesions that are likely to progress to cervical cancer. Keep in mind- this recommendation is only for low risk people- meaning someone without a history of abnormal paps and without multiple partners (cervical cancer is caused by the HPV virus, which is spread by sexual contact).
A Pap test does not test for uterine cancer or ovarian cancer.
A Pap test is NOT necessary to get birth control pills. Never has been, never will be.
A Pap test does not test for sexually transmitted diseases.
The NY Times also reported on the new recommendations. I always get a kick out of the reader comments in the health sections. It contains gems such as this:
This is another good one:
Cervical cancer is cancer and a woman can get it at any age. A pap smear should be part of an annual exam period. Are Insurance Companies going to do away with annual exams as well to save money for themselves. Greed is going to kill us all.
And this one:
It’s quite obvious that insurance companies are behind the effort to restrict cancer screenings for the public, once again putting profits before human lives. We’ve heard the same nonsense regarding mammograms and PSA tests. First they start out telling us we don’t need cancer screenings as often, then their next step will be to deny coverage for tests done more frequently than they want. We all know that cancer can spread like wildfire and these assertions don’t make any sense. Yet another example of disgusting corporate greed.
I love it when people make up their own facts to suit an agenda. I promise you, these new recommendations are not part of some deep, dark conspiracy to undermine women’s health. It’s not being foisted on the American public by greedy insurance companies or doctors.
It’s just good medicine. That’s it. Sometimes it is that simple.