The pap smear is a screening test done during a well woman exam that checks for precancerous or cancerous cells on the cervix. Recently, guidelines have changed about how often a woman should have this screening test.<\/p>\n
Until the early 2000\u2019s, it was not know what caused cervical cancer and the recommendation was for every woman to get a pap smear every year. Once it was discovered that HPV (Human Papilloma Virus) is responsible for 99% of all cervical cancers, the recommendation changed to start pap smear testing 1 yr after becoming sexually active and every year thereafter until age 30. At age 30, a woman who was at low risk and had had no abnormal pap tests could then get tested every 2 years. Women at high risk or who had abnormal results or had dysplasia (precancerous cells) still needed yearly testing after age 30.<\/p>\n
Recently, in December of 2012, new guidelines were announced for pap testing. The new recommendation is now- begin testing at age 21, and every 3 yrs until age 30. If no abnormal paps, test for HPV at age 30. If negative, check a pap smear every 3-5 years.<\/p>\n
Pap results can come back with 4 basic results: normal, ASCUS, LSIL and HSIL; as well as HPV negative or HPV positive. There are over 100 strains of HPV-some cause warts, including genital warts- which are benign, some strains have been identified but it is unknown if they do anything, and 14 strains are considered \u201chigh risk\u201d for cervical cancer. If a test results comes back HPV positive- it is positive for one of the 14 high risk strains (the other strains are not checked).<\/p>\n
ASCUS means there are atypical cells- they don\u2019t look quite normal- and may be caused by many reasons: infection, inflammation, HPV, allergic reaction, etc.<\/p>\n
LSIL and HSIL are higher grade abnormalities that are mostly related to HPV changes of the cervix that may be precancerous or cancerous. They are Low-grade and High-grade Lesions of the cervix.<\/p>\n
If your pap smear is abnormal, your health care provider may need to take a closer look at the cervix. This is called a colposcopy. (Remember the pap smear is just a screening for abnormalities- a brush gathers cells from all over the cervix to be examined by a pathologist for changes that may need further evaluation)<\/p>\n
A colposcopy is a procedure done in the office to get a closer look at the cervix. A colposcope is a microscope that is designed to get a better look at the cervix- the cervix is cleaned and then thoroughly examined with this specialized microscope. If any abnormalities are detected- a biopsy will be taken to see how deep these changes go.<\/p>\n
The cervical biopsy results may be: normal, mild dysplasia, moderate dysplasia or severe dysplasia. Normal tissue and mild dysplasia may require just repeat paps check the area on a preset schedule. Moderate or severe dysplasia require treatment because these cells are becoming more cancer-like. There are many treatments to get rid of the precancerous cells such as : cryotherapy, cone biopsy, laser removal and LEEP- where a wire is used to remove the affected area of the cervix.<\/p>\n
Treatments get rid of the tissue that is changing, not the virus that causes it. HPV is sexually transmitted. According to the CDC, 85% of the sexually active population over the age of 18 is HPV positive. It is important that if you have ever had an abnormal pap that you follow-up with your health care provider to learn when you need to return for your pap smears.<\/p>\n
It is my recommendation that every woman has her yearly well woman exam- at that exam we discuss your risk for cervical cancer and how often you should come in for pap smears. This exam also can include other testing for sexually transmitted infections, a breast exam, family planning and other health maintenance testing such as thyroid screening and\/or screening for diabetes or other problems. We discuss your schedule for mammograms based on your risk level and discuss hormonal changes with peri\/postmenopause.<\/p>\n
If you would like to know more, schedule your well woman exam with me at the Midtown Women\u2019s Center at Saint Anthony\u2019s Medical Plaza downtown OKC. 405-272-8498<\/p>\n","protected":false},"excerpt":{"rendered":"
\u2018Ri Teref-Ta APRN-CNM, MSN The pap smear is a screening test done during a well woman exam that checks for precancerous or cancerous cells on the cervix. Recently, guidelines have changed about how often a woman should have this screening test. Until the early 2000\u2019s, it was not know what caused cervical cancer and the recommendation was for every woman…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0},"categories":[8],"tags":[17,25,28,29],"_links":{"self":[{"href":"https:\/\/cmsmidwife.com\/home\/wp-json\/wp\/v2\/posts\/652"}],"collection":[{"href":"https:\/\/cmsmidwife.com\/home\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cmsmidwife.com\/home\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cmsmidwife.com\/home\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cmsmidwife.com\/home\/wp-json\/wp\/v2\/comments?post=652"}],"version-history":[{"count":0,"href":"https:\/\/cmsmidwife.com\/home\/wp-json\/wp\/v2\/posts\/652\/revisions"}],"wp:attachment":[{"href":"https:\/\/cmsmidwife.com\/home\/wp-json\/wp\/v2\/media?parent=652"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cmsmidwife.com\/home\/wp-json\/wp\/v2\/categories?post=652"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cmsmidwife.com\/home\/wp-json\/wp\/v2\/tags?post=652"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}