Post by Carrie Bonsack, CNM, MS
Did you know January is Cervical Cancer Awareness Month? Honor Cervical Cancer Awareness Month by educating yourself on cervical cancer and how you can help protect yourself. HealthNet Certified Nurse Midwife, Carrie Bonsack teaches you everything you need to know about cervical cancer and answers some of the most common questions!
A pap smear is a test used to screen for cervical cancer. Many of you have had a pap smear every year since you were a teenager. Well, those days are over. It’s a new year and time for celebration that we are all done with yearly pap smears! Some women are worried and feel they need a test every year, but let me reassure you that you do not need a pap smear every year. Read on to find more about pap smears, HPV, and the importance of an annual “well woman” exam.
Why do I no longer get a Pap smear test every year with my annual exam?
In March of 2012, new pap screening guidelines were developed by the United States Preventive Services Task Force (USPSTF) and the American Cancer Society, American Society for Colposcopy and Cervical Pathology, American Society for Clinical Pathology (ACS/ASCCP/ASCP) based upon the woman’s age. Basically, all of these organizations looked at research evidence and found that women do not need yearly pap smears and here is why:
- Cervical cancer is rare, especially in young women.
- Precancerous cells are caused by HPV and it will go away in most young healthy women.
- Testing for cervical cancer may lead to more treatment (more tests, more biopsies, and more surgeries) than necessary and may be doing more harm than good.
- Over treatment may lead to unnecessary short-term anxiety or concern.
- Over treatment may lead to pain, bleeding, or vaginal discharge after certain procedures.
- Over treatment may lead to problems with future pregnancies such as preterm birth and low birth weight babies.
When do I start getting screened for cervical cancer?
A woman should begin having a pap smear at the age of 21. Women between the ages of 21-29 should have a pap smear every three years. Women ages 30-65 should have either a pap only every three years or pap with HPV screening every five years. Women under the age of 21 should not have a pap. (USPSTF/ACS/ASCCP/ASCP, 2012)
When do I stop getting screened for cervical cancer?
If you are age 65 and have had three negative pap smears in a row or two negative pap with HPV tests within ten years, or have no history of CIN 2 within the past twenty years, then you can stop having pap smears. (USPSTF/ACS/ASCCP/ASCP, 2012)
What is Human Papillomavirus (HPV)?
HPV is the most common sexually transmitted infection among both men and women. HPV more commonly infects the genital area, but can also infect the mouth or throat. Nearly everyone who is sexually active will get HPV at some point in his or her lifetime because it is so common. Around 90% of HPV infections can clear on their own within two years. There are over 100 different types of HPV and some can cause genital warts and certain cancers, such as cervical cancer. (CDC, 2013)
Can I prevent HPV?
HPV vaccines can help prevent certain types of HPV, and are available and recommended for 11 and 12 year old boys and girls. Gardasil, an HPV vaccine, is available for males and females. Cervarix is available for females. Women, men, boys and girls between the ages of 13 and 26 can also get these vaccines if they did not get it when they were younger. The HPV vaccines are a series of three shots given over a six-month period. Condoms can help protect against HPV when used from start to finish of the sex act, however, HPV can infect areas not covered by a condom. Limiting your number of sex partners can decrease your risk of sexually transmitted infections. (CDC, 2013)References: Cervical cancer screening among women aged 18-30 years – United States, 2000-2010. (2013). MMWR. Morbidity And Mortality Weekly Report, 61(51-52), 1038-1042.
Moyer, V. (2012). Screening for cervical cancer: U.S. Preventive Services Task Force recommendation statement. Annals Of Internal Medicine, 156(12), 880. doi:10.7326/0003-4819-156-12-201206190-00424
Well-woman visit. Committee Opinion No. 534. American College of Obstetricians and Gynecologists. Obstet Gynecol 2012;120:421–4.