GynoFiles

A new report has been released by the CDC that highlights a new disastrous trend in the US: women are not getting their routine pap smears.  Over 10% of women with insurance and about 24% of women without insurance did not get a pap smear in the past 5 years. It is common for women to tell their provider "oh, it's really been that long". Guidelines for pap testing have changed , but one thing is sure, cervical cancer screening for pap tests is very accurate and successful and screened women do not have to die from cervical cancer. HPV vaccination protects many individuals, but not all cervical cancers have been associated with positive HPV test s. The CDC tracks many screening tests and the current data released is from the 2012 Behavioral Risk Factor Surveillance System survey. Although screening decreased the death rates has remained stable and relatively low. But should this trend of women not getting regular testing continue the death rate will climb. Not only do w...

Cervical cancer detection is more than just a pap smear, it's getting regular pelvic examinations, following up episodes of bleeding or pain, and having a personal gyno to consult regarding how to lower your cancer risks. But, ultimately, most do rely on regular pap smear testing to determine their risk for cervical cancer. Pap smears are a sampling of the cervical cells to determine whether the cells are normal. As such pap tests don't treat cancer, they seek it, as in a simple screening test. Pap smear testing cannot detect all cancer, just most of it, yet who to test, and exactly how to test has been under debate as we try to further eliminate cervical cancer, but focus on safety and cost for American women. Many organizations have produced pap smear guidelines. American Cancer Society recommendations can be found at this lin k  . The American Society for Colposcopy and Cervical Pathology can be found at this link , where they discuss the guidelines that were put in pla...

Are you worried about your pap smear result? If so, gynos might be willing to bet that you are most worried about the uncertainty of what is the correct plan for your pap today. It is true that many new, newer, and now even the newest pap testing and treating guidelines have changed. If you have changed gynos, you may even find yourself getting different advice regarding a particular result. Be aware, that there are many changes and we are going to talk about a few.   The basic answer is that fewer women are going to colposcopy and biopsy, and fewer women after biopsy are going to definitive treatment. The issue is whether the abnormal test is actually cancer, or has a risk of cancer development quickly. If not the experts are urging you and your gyno to delay treatment. Experts have determined that even fairly high grade cervical disease, called CIN 2, or moderate dysplasia has a very high natural regression rate; and though there is no real cure for HPV, these pap problems d...

Hysterectomy means removal of the uterus, so if you have had a removal of the uterus, but your cervix was conserved, you still need pap smears according to the plan established by your gyno. But a woman with no cervix is not routinely recommended to have a pap smear in any of the current guidelines. This includes the organizations: ACS, ACOG, USPSTF, ASC{, ASCCP just to name a few. And don't confuse pelvic examinations with pap smears. Pelvic examinations can determine the health of your vagina, the health of your vulva, the health of your urethra, feel your inner organs, and determine your pelvic floor muscle health, just to name a few of the benefits. If you have had vaginal precancerous changes diagnosed at some point, you also need pap smears. If you have had STD exposure, it is less likely you will get an infection if you have had a hysterectomy, but it is still possible to contract disease, and there are circumstances when STD screening would be indicated even if you have ha...

Pap smears don't treat cancer, they seek it. Pap smear testing cannot detect all cancer, just most of it. Under 21: You probably don't need one. Under 30: Get a regular pap ever 3 years, keep getting pelvic exams. Over thirty? Add a HPV test to your pap. Previous abnormal? You may have recurrence risk for over 20 years. We have told women that they need yearly pap smears for so many years that even though it's been a recommendation since 2003 to do fewer pap smears we are often sticking to the every year pap. And you and your gyno know more about your risks. Drs. Chelmow, Waxman, Cain and Lawrence writing a commentary on this topic in Obstetrics and Gynecology this month (April 2012) have said that the 'yearly' plan was 'chosen arbitrarily.' It's hard for gynos to switch gears, and we didn't embrace the every other or every third year smears as a group. Now again we have  extended the overall interval that pap smears are necessary, and it's all...

Pap test guidelines are changing rapidly, and you may not need a test yearly. You should have a pap test when your gyno recommends that you have a pap test, and remember, pap tests are different than pelvic examinations. Pap tests themselves are an actual sampling of the cervix. The pelvic examination checks you for conditions of the vagina, the vulva, the uterus and the ovaries. The pap smear can pick up abnormal ovarian and uterine lining cells, but that's not primarily what it is aimed to do. As for when to have the test: every year, every other year, every third year or every fifth year will depend on your age, your prior tests and whether you are getting an HPV test also. The guidelines as to when to have a pap do vary very slightly from one organization to the next and they have changed recently. So it's important if you are a mom of a young woman, ask your gyno what she currently recommends for your daughter, it's changed over what she recommended for you! The cur...