Pap Test Pop Quiz
This spring, the U.S. Preventive Services Task Force (USPSTF) released new recommendations regarding when and how often women should be screened for cervical cancer. According to Virtua obstetrician and gynecologist Michael Minoff, MD, these new recommendations have stirred up a lot of conversation and questions among his patients. To stay healthy and informed, it’s important that women have their facts straight on this important topic – take this Pap test pop quiz and see if you’ve got ‘em down pat (and don’t worry, we won’t grade you!).
True or False?
Most women need to have a Pap test done every year.
This is the biggest change to the Pap test recommendations: Whereas once upon a time all women automatically had a Pap test every year, the USPSTF now recommends testing every three years for women ages 21 to 65. The recommendations also indicate that women younger than 21 need not have a Pap test at all, regardless of sexual history. “The American Cancer Society and the American Society for Colposcopy and Cervical Pathology have also backed up the USPSTF recommendations,” says Dr. Minoff, “and while the American College of Obstetrics and Gynecology has yet to weigh in, I’d say the majority of gynecologists, pediatricians and family health practitioners are following these guidelines in their practices.”
That said, women who test positive for HPV (human papillomavirus) or who have low-grade or high-grade squamous intraepithelial lesions (also known as LSIL or HSIL, which are the precursors of cervical cancer that a Pap test is checking for) will likely require repeat testing the following year, or, with HSIL, colposcopy with biopsy.
True or False?
If I test positive for HPV or abnormal cells, it’s likely that my cervix will heal itself over time without medical intervention.
The good news is HPV and mild cervical abnormalities are not necessarily cause for panic. “We know that HPV is generally self-limiting – that is, most healthy women will suppress it in time and the virus will go dormant,” says Dr. Minoff. As for abnormal cervical cells: “When I talk to my patients who receive an abnormal Pap result, I like to use a staircase metaphor. At the bottom of the staircase is a healthy, normal cervix and at the top of the staircase is cervical cancer. There are many, many steps in between, and for most women, even if they go up a few steps, they generally come back down on their own without a physician having to do anything.
“We screen at regular intervals just to make sure you’re not continuing up the staircase.”
True or False?
If I don’t need to have a Pap test, I should skip my annual GYN exam.
Regardless of whether it’s your year to get a Pap test, an annual gynecological exam is essential for maintaining good health. “That annual appointment covers all kinds of issues. Your doctor will still need to examine the vagina and cervix, as well as the breasts, abdomen, and pelvis. The doctor will cover topics like menstruation, hormones, fertility, contraception and any problems that may have arisen in the past twelve months,” says Dr. Minoff. “Some women see these new recommendations and think ‘I don’t need to go to the doctor once a year anymore,’ but that’s simply not true.”
Also, the fact that women under 21 need not have a Pap test does not mean they shouldn’t start seeing a gynecologist earlier on. “Any young woman who becomes sexually active or is having any issues with their period, pelvic pain or unusual discharge should begin to see a gynecologist at least annually,” says Dr. Minoff.
True or False?
Once I hit my 66th birthday, I don’t ever need to be screened for cervical cancer again.
Unless there is a history of moderately or severely abnormal cervical cells, women over 65 need not continue having Pap tests. “This is true even if you have a new sexual partner later in life,” points out Dr. Minoff. “But even for these women, annual exams remain important.”
Overall, no matter your age or personal Pap test timeline, Dr. Minoff recommends establishing a good relationship with a gynecologist you trust. You’ll benefit from a doctor that knows your full history, and you’ll be more likely to proactively pursue the annual visits necessary to keep you in good health.