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The Doctor Is In - Preventing cancer starts with the annual Pap test

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Stacey Yell, M.D.

Posted: Wednesday, May 2, 2012 4:00 am

For busy women who typically put others’ needs before their own, remember that taking time to care for themselves is important to good health. Regular well-woman exams are a simple and effective way to start.

The principal parts of a well-woman visit are a routine pelvic exam – which checks the uterus, ovaries and other organs to make sure they are healthy – and a Pap test, which screens for certain gynecological cancers. The Pap smear is the primary test for cervical cancer: once one of the most common causes of cancer death among women, today it is one of the easiest cancers to detect and prevent.

What is the Pap test?

This test is used to detect cell changes in the cervix that may later develop into cancer. Because cervical cancer is slow-growing with few symptoms in the early stages, the Pap test is an effective tool in early detection. Usually performed during a pelvic exam, the Pap test collects a few cells from the cervix for examination under a microscope. The test is painless, and takes only seconds to perform. Regular Pap smears monitor any tissue changes in the cervix and can help diagnose potential problems early, when they are most treatable.

Who needs a Pap test?

The Pap test is recommended for all women; however, industry guidelines regarding when to begin Pap tests and how frequently to receive the test have changed. Women are now advised to get their first Pap test at age 21 (previously, the recommendation was to begin having the test three years after becoming sexually active, or at age 21, whichever came first.) Once you’ve had your first Pap test, repeat Pap smears should follow these guidelines, issued by the American College of Obstetricians and Gynecologists (ACOG):

Women ages 21 to 30 should have a Pap test once every two years unless they have had an abnormal Pap test or have other risk factors.

Women who have received the HPV vaccine should follow the same schedule and guidelines for Pap smears.

Women age 30 and older who have had three consecutive negative tests – and no abnormal history or risk factors – should have repeat Pap tests once every three years.

Women age 30 and older can also optionally be tested for cancer-causing types of HPV,  at the same time as their Pap test. Because HPV diagnosed in women under age 30 is often cleared by the woman’s own immune system, routine HPV testing for younger women is not recommended.

Women with certain risk factors may need to be screened more frequently as recommended by their doctor. These risk factors include HIV; a weakened immune system due to cancer, organ transplant or other illness; exposure to the drug diethylstilbestrol (DES) before birth; or a history of moderate to severe dysplasia (i.e., pre-cancerous cell growth on the cervix).

Women age 65 and up who have had no abnormal Pap smears for 10 years, and three or more negative results, consecutively, may stop getting Pap tests, with the permission of their doctor.    

Women who do not have a cervix, including those whose cervix has been removed as part of a hysterectomy, do not need regular Pap tests.

Cervical cancer is most often diagnosed in women age 40 and older. It is important to continue getting a Pap test regularly – even if you think you are too old to have a child, or are not sexually active. It’s equally important to continue annual pelvic exams, regardless of the recommended frequency of Pap tests. Your pelvic exam and Pap test may be performed together, in the same wellness visit, or separately, depending on the frequency of Pap tests that your doctor recommends.

(Editor’s Note: Dr. Stacy Yell is a gynecologist with Northwest Allied Physicians.  Her office may be reached at 232-5280 or www.mytucsondoc.com.)

© 2014 The Explorer. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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