Why a PAP Test Is so Important

The most effective early cervical cancer detection method available today is the Pap test, or Pap smear. It is a simple procedure that involves swabbing a small sample of cells from a woman's cervix and transferring them to a slide. The cells are then examined and evaluated by a certified laboratory.

Women should begin having regular Pap smears at age 18 or earlier if they are sexually active. There is some disagreement about when women should stop having Pap smears. Some say there is no upper age limit; others suggest having your last Pap smear at age 65 if there is no history of problems. Talk with your doctor about your situation.

Done regularly, Pap smears make it possible for doctors to find early evidence of cervical cancer. This can be done before any visible symptoms are present, when the disease is easier to cure.

Cervical cancer is one of the most common female cancers in the United States. It is diagnosed in an estimated 13,500 women yearly. About 4,400 women die each year from the disease. For those women diagnosed early, the survival rate is 89 percent. If the disease hasn't spread, the survival rate is virtually 100 percent.

Thin Prep Test
In 1998, our office began offering the Thin Prep Pap test, an improved technology over the standard Pap smear. There is no difference in how the sample is collectedfrom you(unfortunately), only in the way that the laboratory processes it. Thin Prep has been shown to detect more severe precancerous lesions earlier than the old smears. It also has recently been shown to decrease the number of indeterminant, inflammatory, and atypical results that require you to get repeat tests done. We have been very impressed with our experience using Thin Prep and the majority of our patients now select it. Almost all insurances cover the test which is more expensive than the standard test. One notable exception is Masshealth.

However, it should be noted that the ultimate goal of all Pap smears is to prevent you from ever getting cancer and to detect it early if you do. To that extent, Thin Prep is not clearly superior to the old Pap smear, which for the most part does an excellent job. Also newer technologies are currently being studied which may further improve cervical cancer detection and prevention, including vaccines to the HPV virus which are currently finishing phase 1 trials. We will keep you updated.

Scheduling Pap Smears

Most women consider the Pap smear and pelvic exam to be the major part of an annual checkup. The tradition has been to have a "yearly Pap and pelvic." However, a panel of experts analyzed the most recent scientific and medical research about Pap smears and concluded:

• While it is extremely important to have Pap smears on a regular basis, it is no longer considered necessary for most women to have a Pap smear every year. Because most cervical cancers grow very slowly, a Pap smear done every 2 to 3 years will provide the same early detection benefit as an annual Pap smear.
You may be able to extend the interval between Pap smears to 2 to 3 years if you have had annual normal Pap smears for at least 3 years in a row (documented in your medical records). More frequent Pap smears are still recommended for women with a history of abnormal cell changes that may lead to cancer in the next 5 years, for women with new sexual partners, and for women who are HIV positive (or otherwise immunosuppressed).
• You and your doctor can decide together on a Pap smear schedule that is most appropriate for you. Remember that even though you may not need a Pap smear every year, you may still need an exam every year, including a breast and pelvic exam.
• Try to schedule your periodic health exam (that may include a Pap smear) to take place about 1 week before the start of your period. If this isn't possible, at least try to avoid the days when your menstrual flow is heaviest.
• Don't use a vaginal douche or any type of vaginal medication or lubricant for 24 hours before having a Pap smear.
• Help your physician determine the Pap smear schedule best for you by:
  • Telling him or her the approximate dates of your previous Pap smears.
  • Discussing any concerns you may have about waiting 2 to 3 years between Pap smears.

Source: Patient education material from the American College of Obstetrics and Gynecology was used as a source of information to develop the content for this topic.

Related Links