No longer does an annual gynecological appointment require a Pap test or an HPV screening. At my recent appointment, in lieu of a physical exam, I spent my time asking about the new guidelines and clearing up confusion.
In 2009, there were 4,000 U.S. deaths* related to cervical cancer and of those cases many of the women had never been screened or, if they had been screened, it was over a decade before their diagnosis was made. An HPV infection takes ten years to develop into cervical dysplasia or cervical cancer. With that in consideration, the maximum time between Pap exams should be under ten years.
The new guidelines indicate that routine yearly testing is too frequent. 95% of HPV related cervical abnormalities detected on a Pap are of no consequence to a woman’s health and HPV resolves on its own within a year or two. Currently, when HPV is discovered during an annual Pap, patients become unnecessarily anxious and clinicians tend to treat the diagnosis prematurely.
The additional testing and treatments for HPV infections and abnormal Paps involve scraping the cervix or removing a part of the cervix resulting in scar tissue. These procedures have shown to be extraneous and result in compromising the cervix. The cervix is weakened and cannot support the weight of a fetus during pregnancy which can result in miscarriages. A negative colposcopy will give an HPV+ woman piece of mind, but it might prevent her from carrying a baby to term when she’s ready to bear children.
There is also the issue of practitioners performing unnecessary procedures for profit. Many patients, regardless of gender, respect the recommendation of their medical provider and consent to unnecessary interventions. The new guidelines help to reduce fraud.
The United States Preventive Services Task Force, the American Cancer Society, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology have all published data to support the new screening guidelines for women.
Here are the new guidelines:
- Women should start screenings no earlier than age 21.
- Women age 21 to 65 should get a Pap test every three years.
- Women over 30 should combine the Pap test with HPV testing every three to five years.
- Screening is not recommended for women 65 or older who have had three normal Pap tests in a row and no abnormal Pap test results in the past 10 years, or who have had two or more negative HPV tests in the past 10 years.
- Women who have a normal Pap result and a positive HPV test result should repeat both tests in one year. There is no immediate need for a colposcopy.
- Women who have been vaccinated against HPV should begin cervical cancer screening at the same age as unvaccinated women (age 21).
- Women in their 50s or 60s who were exposed to DES in utero and women who are HIV+ are considered high risk and should have more frequent Pap and HPV testing.
Please remember that the new guidelines are effective in preventing cervical cancer but they do not prevent the spread of HPV. Men transfer the virus from woman to woman without symptoms and there are currently no approved or recommended tests to screen men for HPV. If you become infected, maintain optimal physical and mental health to aid the virus in clearing your system. Taking complex-B vitamins will boost immunity.
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