New Guidelines for the Pap Smear

The Babes-Papanicolaou test, better known to us as the Pap smear, Pap test, cervical smear or smear test, was invented by and named after a Greek doctor by the name of Georgios Papanikolaou. This test was developed as a screening tool used to detect potentially cancerous cells in the cervix of the uterus. The use of the test has been instrumental in catching cancers and preventing cervical cancer. It has been proven over time to detect the earliest signs of cervical cancer and, with the aid of this test, lives of women have been spared.

US Preventive Services Task Force Provides New Guidelines for Pap Smear

Until March, 2012, the suggested guidelines recommended women to have a Pap smear every year. However, new guidelines issues on the 15th of March, 2012, indicate that women only need to be screened once every three years for cervical cancer. The US Preventive Services Task Force has now declared an annual Pap test is no longer necessary for women between the ages of 21 and 65. They add that women under the age of 21 are eliminated from testing because evidence indicates screening has no effect upon the lowering of deaths as a result of cervical cancer in the younger age group. Until now, the recommendation was for young women to be tested beginning three years after they became sexually active, which could put them as young as 17 or 18 years of age.

The task force concluded that screening done every three years after 21 years of age has the same success rate for saving lives as yearly screening, with half the biopsies and fewer false-positive results. The Annals of Internal Medicine published the results of the findings of the task force.

Previous Guidelines for Pap Smears, 2003

According to the US National Cancer Institute, more than 12,000 women are diagnosed with cervical cancer each year and 4,000 die from it. Pap smears are designed to detect abnormal cells taken from the cervix.

The recommendation for testing in the 2003 revision was to have a Pap smear and pelvic examination as part of routine health care for women 21 years of age and older. Women over the age of 65 who had three or more normal Pap tests with no abnormal results have been able to stop regular testing. The suggested testing calendar looked like this:

· Starting at age 21, have a Pap test every two years

· If you are 30 years of age or older and have had three normal Pap tests in a row, it is possible to space the testing to once every three years

· Over 65, it is possible to stop testing with the doctor's consent

More frequent testing has been recommended in situations where:

· A woman has a weakened immune system due to organ transplant, chemotherapy or steroid use

· The mother of the woman was exposed to diethylstilbestrol (DES) while pregnant

· HIV positive


Changes to the Guidelines for Pap Smears, 2012

The new testing guidelines lengthen the time between Pap smears and recommend co-testing for both a Pap smear and an HPV test. HPV is human papillomavirus and is a common sexually transmitted disease that is responsible for most cases of cervical cancer. The HPV test shows whether a woman has been infected with the virus which allows for surveillance and early testing, determining if the virus has caused precancerous cells to form in the cervix.

The new guidelines, broken down by age group and health history, say:

· Women between ages 21 and 65 can safely extend cervical screenings to every five years if they undergo a human papillomavrius (HPV) test at the same time as their Pap smear.

· Women older than 65 who have had prior screenings and are otherwise not at high risk no longer need Pap smears. In the event of high-grade cancerous lesions, testing should continue for an additional 20 years.

· Women under 30 should not undergo HPV testing since the infection is prevalent in younger women and often clears on its own.

· Women who have had a hysterectomy with the removal of the cervix and have no prior history of cancerous or precancerous lesions do not require screening.

One of the lead authors of the new guidelines, Dr. Wanda Nicholson, said, "The most important point we want to make is that the highest-risk women are those who have never been screened or haven't been screened in over five years."

Dr. Diana Contreras, division direction of obstetrics and gynecology at Long Island Jewish Medical Center in New Hyde Park, NY agreed with this statement saying, "This is a cancer we could get rid of in this country if we were able to screen everyone who needs it." She added that women should continue annual visits to their gynecologists to continue to monitor other aspects of their reproductive health.

Learn about abnormal Pap tests, what they mean and how they are discerned in our article on this site.

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