Elizabeth Campbell, M.D., from the University of Michigan Health Von Voigtlander Women’s Hospital, has noticed a recurring discussion with her new patients – confusion about Pap smears and HPV tests. Many patients are uncertain whether their previous OB-GYN ordered one or both of these screenings to check for cervical cancer or abnormal cells. While both procedures involve collecting cells from the cervix, they are tested differently in the lab.
Campbell emphasizes the importance of patients being aware of the screenings they are receiving and staying informed about the current recommendations. It appears that many individuals who were assigned female at birth still believe they are only receiving a Pap smear, despite the most recent guideline change in 2021.
A Pap smear, named after physician George Papanicolaou who discovered it in 1928, looks for abnormal cells in the cervix. This screening played a crucial role in significantly reducing the death rate from cervical cancer among American women. On the other hand, an HPV test looks for specific high-risk subsets of the human papillomavirus that are linked to cervical cancer.
It is essential to understand the difference between the two screenings and recognize that even if someone has received the HPV vaccine, regular screening for the virus is still necessary. The American Cancer Society estimates that close to 14,000 new cases of cervical cancer will be diagnosed in the United States in 2023.
Regarding the frequency of Pap smears, the guidelines from the American College of Obstetricians and Gynecologists recommend:
When it comes to sexually active teenagers, Pap smears are no longer necessary. Campbell explains that the likelihood of significant developments before turning 21 is extremely low. Additionally, younger individuals are more likely to clear the HPV virus naturally without it posing a significant risk for cervical cancer.
However, certain exceptions exist for veering from the Pap smear guidelines based on an individual’s medical history. For example, those who have undergone a total hysterectomy, which removes both the uterus and cervix, no longer face the risk of cervical cancer. Exceptions to this rule include patients who had a hysterectomy due to cervical pre-cancer or cancer. They should continue to have Pap smears of the vagina to check for vaginal cancer.
Another aspect that patients should clarify is the type of surgery they have undergone, as this information can influence their long-term health care planning.
Even after menopause, individuals are at the highest risk of developing cervical cancer between the ages of 40 and 50. Therefore, it is crucial for these individuals to continue with regular screenings.
Preparing for a Pap smear is now easier, as Campbell explains that previous rules are no longer in place. Patients can have a Pap smear while on their period, and there is no longer a need to abstain from intercourse beforehand. These factors will not impact the ability or interpretation of the Pap smear. Campbell understands that some individuals may need more time to mentally prepare for a pelvic exam, but there are no longer restrictions in place.
In summary, understanding the differences between Pap smears and HPV tests is crucial for patients. Being informed about the current guidelines and asking questions about the screenings being conducted can help individuals take control of their healthcare. Regular cervical cancer screenings remain vital in the fight against this disease, regardless of HPV vaccination status.
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