Do I really need a pap smear?

So with all the changes in healthcare guidelines you may be wondering if you really need a pap smear. I'm going to go through a few of the new guidelines with you, but remember, it's always safer just to get the exam.

My first big disclaimer is that there is more to a physical exam than just a pap smear! There are many other issues that we like to address at your physical such as diet and exercise ( I know, you don't want to hear it), good heart health (still the leading problem in women), emotional wellbeing, menopause, irregular periods, breast and skin exam etc. etc. Depending on your age and healthy you may not need a physical every year but you need to talk to your doctor about that.

Now, for cervical cancer. The only thing that a pap smear checks for is cervical cancer. Sure, we may get a little yeast on the smear, and sometimes some endometrial cancer cells, but the purpose of the pap is to screen for cervical cancer. We know that cervical cancer is from the HPV virus (Human papilloma virus). This is sexually transmitted but it can be skin to skin contact and not penetration. It is a very, very common virus. There are many strains of this virus. A handful cause cervical cancer and a handful cause genital warts. Unfortumately, you can not tell if you have the virus that causes cancer until you start getting precancerous cells on your pap smear. Occassionally we will check if you have the virus but this is not covered by insurance except in certain conditions. Sooooo, you have to get your pap smear if there is any chance you may have been exposed to the virus in your lifetime.

Okay, now I know that there are many of you that say it is impossible for you to have a STD as you and your partner have been monogamous. I really wish that this was always the case and that all partners were faithful. Not wanting to cast any doubt on your true love, I'd still recommend getting a pap smear per the following recommendations. I've seen too many surprised women and blushing men.

So here are the current recommendations from the American College of Ob/Gyn (ACOG);

Young women under 21 should not get a pap smear. Young women have great immune systems and even if they get the virus their bodies can usually fight it off.

Paps should be done every 2 years from 21-29 years

Women 30 and older, if they have had three consecutive negative paps, and no prior history of precancerous cells (CIN) and no medical conditions that compromise their immunity, and get their paps every 3 years.

Women who have had a hysterectomy and no history of abnormal paps can forgo any further pap smears.

Women over 65 with no prior abnormal paps, can stop having paps.

Women with prior abnormal paps needs to continue to be screened for at least 20 years after treatment.

Women who have had the immunization should still follow the above guidelines.

There. I hope that helps. Again, I want to stress that appointments for physical should go well beyond just a pap smear. A yearly pelvic exam may still be needed to screen for other cancers such as ovarian, vulvar and colon cancers. Addressing other issues in your life should be equally as important and hopefully, as your physician we can make these appointments worthwhile!