For many of you that have visited the office in the last few months and had a pap smear, you may remember me saying, “I think the guidelines are going to change some day soon, and we won’t have to do paps quite so frequently.” That beautiful day is today. The American Congress of Obstetrics and Gynecology (the body that makes evidence-based recommendations for practicing providers to follow) just this month has made some new recommendations regarding normal paps and how frequently they need to be performed. Please note, these are NOT the recommendations for anyone that has a history of an abnormal pap. You may want to talk with your provider to if you have a history of an abnormal and are wondering about frequency of pap smears. Here are the ACOG November 2012 updated pap guidelines (#2 and #3 are NEW from the 12/2009 ACOG update).
1. No paps are necessary before age 21.
2. Women ages 21-29 need pap smear (without HPV testing) every 3 years.
3. Women ages 30-65 need pap smear WITH co-testing for high risk HPV (Human Papilloma Virus) every 5 years. Alternatively, women ages 30-65 could have paps without HPV co-testing every 3 years.
4. If a woman has undergone a hysterectomy with removal of her cervix and she has no history of cervical dysplasia (greater than or equal to Cervical Intraepithelial Neoplasia 2—CIN 2), she needs no more paps for the rest of her life.
5. Women can stop paps at age 65 if they have never had CIN 2 or worse cervical dysplasia, and have had 3 normal paps in last 10 years (or 2 normal paps with negative HPV testing).
Please know, all though we are not collecting cells from the cervix to screen for cervical cancer with a pap every year, we DO need to screen for other cancers every year at your annual visit with your OB/Gyn provider. We still need to do breast, uterine, and ovarian exams, keep an eye on blood pressure and cholesterol, and check in for other risk-reducing preventative health care. Your OB/Gyn providers are more than happy to review