Your Annual Pap Smear May Be Changing -- And Not for the Better

doctor talking to woman

Every now and then, a group of researchers decide that women's annual visits to the gynecologist need to be different in some way or another. For instance, in 2011, a group called the U.S. Preventive Services Task Force said they believe women under 65 only need to have Pap tests every three years, because studies suggest there is "little added benefit" to more frequent testing. Oookay. Now, similar new "guidance" says women over 25 should skip Pap tests altogether ... If your head is spinning, you aren't alone!


Here's the deal: The recommendation comes from the Society of Gynecologic Oncology (SGO) and American Society for Colposcopy and Cervical Pathology (ASCCP) who say having just the HPV test -- in other words, not a Pap smear or even a Pap smear and an HPV test -- is best for women over 25. They came to this conclusion upon doing a review of 11 studies, one of which found screening with Human Papilloma Virus (HPV) testing was more effective at predicting risk of cervical disease than a Pap test alone.

So what's really the difference between the two tests?

"The pap smear looks at the cells on the cervix to see if they have any changes (mild, moderate or severe) that are on the progression from normal cell to cancer cell," explains Joel Evans, OB/GYN, MD, founder of The Center for Women's Health in Stamford, Connecticut. "Human Papilloma Virus (HPV) screening looks for the presence or absence of HPV, the virus that can cause cervical cancer."

All right, so ... does it really matter if your doctor only does one test over the other? In short, yes.

Ninety-five percent of cervical cancers are caused by HPV. However, simply having an HPV test without a Pap test wouldn't necessarily have women 100 percent covered, warns Brett Worly, OB/GYN, MD at the Ohio State University Wexner Medical Center in Columbus, Ohio.

"There are some cancers not caused by the HPV virus," Dr. Worly explains. "Eliminating the Pap and relying on the HPV test alone would mean that the screening opportunity for those other cancers would be missed."

That said, as with any new recommendation like this, it obviously pays to have a conversation with your gynecologist about what screenings (and screening schedule) will make the most sense for you. Feel free to do your own research before an appointment, and go in with questions you want to ask. After all, we're all our own best health advocates.

"What this comes down to is the personal philosophy of each woman," says Dr. Evans. "I feel it is best to have as much information as possible, so that safe and natural interventions can be utilized to help protect the cervix from developing a cancer."

Would you be comfortable skipping the Pap test at your next annual exam?


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