"Yippee! Pap Tests Every Three Years!"
According to a new study reported in Medscape Medical News, cervical cancer screening can be done only every three years rather than the previously recommended annual screening. But hold on there, Missie! Before you go jumping for joy and deleting your regularly scheduled gynecology appointment from your calendar for the next three years, let’s look a little closer.
The American College of Obstetrics and Gynecology (ACOG) has been recommending three year follow-up for women with a negative Pap test and a negative HPV test (a test for human papillomavirus, the virus that can cause cervical cancer), though this has not been widely adopted by practicing physicians. This study, by Hormuzd Katki, PhD from the National Cancer Institute, suggests that the HPV test alone could be used every three years. Katki and his researchers found that the 5-year risk of cervical cancer with a negative HPV test alone was not appreciably lower with the addition of a negative Pap test and that the Pap test could be reserved for use with positive HPV test results only. His research supports the adoption of the ACOG guideline and actually goes further by suggesting Pap tests only if the HPV test is positive.
But whether for a Pap test and/or for HPV screening, it is vitally important for women to have routine exams. An annual, well woman exam is important for other reasons than cervical cancer screening and may include STD screening, breast exams, hormonal evaluations and other indicated components.
Many women have had the misconception that a pelvic exam always involves a Pap test. For example, some women who have had a pelvic exam in the emergency department believe they had a Pap test at that time, while most ER physicians will tell you they haven’t done a Pap test since medical school, though they routinely do pelvic exams when indicated. The Pap test is just one component of a well woman exam, just like vaccinations are just one component of a well baby exam.
While the scientists and journalists have done their jobs by reporting these facts, the general population must interpret them accurately, not only in regards to what they are saying, but also what they are not saying. Women must continue to receive annual exams from their gynecologists, whether or not that includes a Pap test and/or an HPV test – or neither test.