Why You Should Still See Your GYN Every Year, Even If You Don’t Always Need a Pap
Some women don't need a pap test every year, thanks to new official recommendations. But do those recommendations apply to you? And does it mean you can skip your checkup altogether? Not so fast.
Inspiring/shutterstockCervical cancer can be deadly, but only half as many people are dying from it nowadays. This reduction coincides with widespread cervical cancer screening, which can identify pre-cancerous cells before they have a chance to become cancer. In fact, about half of all cases of cervical cancer these days are in women who haven’t had proper screening, according to the U.S. Preventative Services Task Force, an independent group of nationally recognized experts in the prevention of disease. (Read up on what doctors want you to know about cervical cancer.)
Recently, the Task Force officially recommended that women between the ages of 21 and 65 should have a pap smear every three years, and that women between the ages of 30 and 65 can go as long as five years between testing if they opt for both the pap test and testing for HPV (human papilloma virus), a virus that is known to cause up to 90 percent of all cervical cancers. (Here’s what you should do if you have an abnormal pap smear.) But it’s tricky to know if these recommendations apply to you or whether they mean you can skip your annual gyno visit. Not so fast.
Standards of care may differ
First, while the Task Force’s recommendations summarize the overall evidence as it applies to the general population, the pap test is only one source that your doctor will consult in making health care recommendations, says Pamela Promecene, MD, an obstetrician-gynecologist and professor with McGovern Medical School at the University of Texas Houston/Childrens Memorial Hermann Hospital. In this case, the Task Force’s recommendations mirror those of the American College of Obstetrics of Gynecology (ACOG), points out Renée Volny Darko, DO, an OB/GYN practicing in Pennsylvania. However, a woman’s individual medical history is paramount, says Kyrin Dunston, MD, FACOG, an OB/GYN with more than 20 years of clinical experience.
For women who are “low risk” in terms of developing cervical cancer, the Task Force’s recommendations make sense, according to Dr. Dunston. Still, being “low risk” is an individual picture that depends on many factors, including:
- no prior history of HPV
- no prior history of other sexually transmitted diseases
- no previous abnormal pap smear
- monogamous partner and/or regular use of condoms
- HPV vaccination
Women who don’t fall into the “low risk” picture may need to have annual screening, Dr. Dunston says.
There’s no substitute for a visit to the doctor
Second, a pap smear should not be synonymous with a checkup, says Dr. Promecene, who believes that while many women don’t need an annual pap test, every woman should visit her doctor annually. “Routine health care visits provide an opportunity to go over one’s medical history and health practices. They allow open and honest dialogue about what are ultimately intimate health care details. They allow a patient to ask questions, better understand the facts, and determine the best course of action for routine testing.”
In addition, separate and apart from performing a pap test, an OB/GYN performs a pelvic exam to assess whether the woman’s pelvic organs look and feel normal, points out Dr. Darko. The Task Force specifically declined to make recommendations regarding annual pelvic exams for the early detection and treatment of conditions apart from cervical cancer.
Here are the cervical cancer symptoms you may not know to watch for.