Cervical Cancer Screening

Did you know in the past year the guidelines have changed for women with regards to cervical screening?

In May of 2012, the American Congress of Obstetritians and Gynecologists (ACOG) released their current recommendations, which may allow you to wait longer between PAP smears.  According to ACOG, most cervical cancers are found in women who have never been screened or have not been screened in the last 5 years.  Because the cervical cancer is typically very slow growing less regular PAPs would still be able to pick it up before it could spread.

Benefit vs Harm

Annual cervical screening is thought to lead to a large number of unnecessary procedures and treatments. The prevalence of the virus associated with cervical cancers is high, but the cervical cells will likely return to normal within 1 to 2 years as your body is capable of fighting off the infection. The small fraction of cervical lesions that do not regress will, on average, require many years to progress to cancer. Identifying and treating abnormal cells that will likely return to normal on their own does not provide a benefit great enough to outweigh the harm of treatment.

These harms may include anxiety associated with a “positive” cancer screening test, potential stigmatization from the diagnosis of a sexually transmitted infection, discomfort from additional diagnostic and treatment procedures, bleeding from treatment, and, longer term, an increased risk of pregnancy complications such as preterm delivery in women previously treated with excisional procedures for precancerous lesions, or difficulty getting pregnant due to narrowing from scar tissue around the cervical opening.

Current PAP recommendations:

• Beginning at age 21 regardless of sexual history.  HPV vaccine does not change screening recommendations.
• Age 21-29 screening every 3 years
• Age 30-65 screening every 5 years if negative for HPV and not high risk
• After age 65 if no recent abnormal PAP can discontinue screening

Note: the new guidelines are for women at average risk. More frequent testing may be appropriate for women with conditions that place them at an increased risk of cervical cancer, such as immunocompromised or human immunodeficiency virus (HIV) infection.

Remember you still need to come in every year for your wellness exam which includes a full physical exam with both breast and pelvic exams.  Wellness exams may also include other screening recommendations based on age and routine blood work.  If you’re due for a physical exam and want a comfortable and relaxed environment, schedule your next wellness exam at RenŪ Progressive Medicine.  We offer routine exams, testing for sexually transmitted infections, contraception, breast and pelvic health counseling, hormone balancing and replacement, and natural approaches to optimizing fertility and prenatal care.