Do I Still Need To Get Pap Smears? ASK AN OBGYN

Dear SuzyKnew! A few weeks ago, I heard on the news that the Pap smear may not be used anymore and that there is a better test to detect cervical cancer.  What’s the deal?

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Sorry, no professional body of doctors has recommended getting rid of the Pap smear.  So you are not off the hook!  But there is a new test that you may get at your next annual exam.

For decades, the Pap smear has been the gold standard.  You know the one- during a pelvic exam; your doctor takes a swab of cells from your cervix.  These cells are sent to a lab for processing and an abnormal result means that you could be at risk for developing cervical cancer.  An abnormal result means you return for more testing and if needed your doctor takes a larger sample of tissue.  But there is a new kid on the block- a test recently approved by the FDA that specifically looks for the presence and type of HPV virus.

 Why this new test? 

With any test or treatment, doctors want to be as specific as possible so that they can target the treatment and rule out other possible causes of illness.   Because we know that there is a clear link between cervical cancer and the human papillomavirus (HPV), and almost all cervical cancer is caused by specific genotypes of HPV, doctors are now thinking, “why not add a cervical screening test that looks specifically at HPV?”   Guidelines from the American College of Obstetricians and Gynecologists state that women aged 21-65 could have both the HPV and the Pap test when they have a cervical cancer screening every three to five years.  There is no test to determine whether you are HPV positive or negative (unlike an HIV test), but the HPV cervical cancer screening can help detect and therefore reduce the cervical cancers caused by HPV.

HPV is an STI?

Yes. Approximately 30 strains of HPV are spread through sexual contact.  In fact, its one of the most common STIs.   The CDC estimates that 79 million Americans are currently infected with HPV. About 14 million people become newly infected each year. HPV is so common that most sexually active men and women will get at least one type of HPV at some point in their lives. Rates of HPV are higher for women under 25, minorities and those with multiple partners.

 If I have HPV will I get cervical cancer?

No. There are hundreds of strains of HPV, and most HPV strains are harmless, at worst causing warts on the hands.  Most resolve on their own with no treatment.  But a few specific strains of HPV are more dangerous than others, and we also know which strains of HPV (namely 16 and 18) are directly linked to the development of cancer. HPV can cause cervical and other cancers including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in the back of the throat, including the base of the tongue and tonsils (called oropharyngeal cancer).

SO what can I do to prevent cervical cancer?

There are three ways to prevent HPV and lower your chances of contracting cervical cancer:

  •  Get Vaccinated. HPV vaccine is safe and effective. It’s given in three shots over six months; it is important to get all three doses. It’s only effective in young people.  All boys and girls ages 11 or 12 years should get vaccinated. Catch-up vaccines are recommended for males through age 21 and for females through age 26, if they did not get vaccinated when they were younger.
  •  Get screened for cervical cancer. Routine screening for women aged 21 to 65 years old can prevent cervical cancer. Next time you go for your annual exam, ask your health care provider if they are using both the Pap smear and an HPV-specific test.  You can share the information you have learned from Suzy Knew!
  • Have safe (protected) sex. HPV can be spread through all types of sex, vaginal, anal oral sex.

Take care.