Should you trade your Pap for the HPV test?
For years, the only way to screen for cervical cancer was with a Pap smear. Last May, the FDA approved the first alternative method: the HPV test.
Unlike a Pap that detects abnormal cervical cells, the HPV screens for the DNA of different strains of HPV (there are more than 100 types). These can be of the low-risk variety that only cause genital warts or of the high-risk variety that can lead to cervical and other types of cancer.
The American College of Obstetricians and Gynecologists (ACOG) used to recommend a Pap every year. This recommendation has changed recently. The new Pap guidelines suggest:
- Women ages 21-29 should have a Pap test every 3 years.
- Women aged 30-65 years should have a Pap test and an HPV test (co-testing) every five years (preferred). It is acceptable to have a Pap test alone every three years.
- After age 65, women may stop screenings if they do not have a history of moderate or severe dysplasia or cancer and they have had either three negative Pap test results in a row or two negative co-test results in a row within the past ten years, with the most recent test performed within the past five years.
- Women who have a history of cervical cancer, are infected with HIV, have a weakened immune system, or who were exposed to diethylstilbestrol (DES) before birth should not follow these routine guidelines.
For women who do not fit the new guidelines, it is recommended that you have exams more frequently than every five years. Depending on your specific situation, your doctor will provide you with an appropriate exam schedule to follow.
HPV Positive Results
Be aware that sometimes the HPV test will catch a positive HPV in women who have had all normal Pap smears previously. You should not panic about this. HPV is usually transient and is very common – 60 percent of women will get it in their lifetime if they are sexually active. It simply means you should not opt for the every five-years screening.
Do I Still Need an Annual Exam? YES.
You should continue to have a pelvic exam and a breast exam every year whether or not you are doing a Pap smear. The annual exam is a very important time to discuss your women’s health concerns, including contraception, plans for pregnancy, pelvic pain, menopause symptoms or problems with abnormal bleeding and to address fibroids, ovarian cysts or endometriosis.
Your Genesis OB/GYN physicians and nurse practitioners look forward to seeing you for your annual exam.
Tips for your annual exam
- Schedule when you are not menstruating. Menstrual blood can impact Pap test results. ACOG recommends scheduling your exam after you have completed your period.
- Speak up if you are uncomfortable. Gynecological exams can be difficult. Tell your doctor if you have experienced sexual abuse or assault, if you have pain before the exam, if you have panic attacks, if this is your first exam or any other reason that might make you fearful. Your doctor is happy to make accommodations to help you feel more comfortable.
ACOG Fact Sheet: New Guidelines for Cervical Cancer Screening
Fact Sheet: Pap Tests – US Office on Women’s Health
FDA Ruling cobas viral DNA test for HPV safe and effective for cervical cancer screening