First of all, what is a pap smear? A pap is a screening test where cells are taken from the cervix and examined under a microscope to look for cancerous or pre-cancerous changes. It is also used to pick up infections with the human papilloma virus (HPV), which is responsible for cervical cancer. The pap is not a diagnostic test—it simply tells us that further testing may be necessary. This further testing is called colposcopy and involves looking at the cervix under magnification. If abnormalities are seen, a biopsy is then performed to obtain tissue from the cervix. This tissue is examined under the microscope and a diagnosis is made. It is important to understand that a pap smear is used to pick up changes in the cervix (or top of the vagina if you’ve had a hysterectomy) only. It tells us nothing about the uterus, ovaries, fallopian tubes, or labia.
This brings up a very important point, which is crucial for patients to understand: the pap is a test, not an exam. If your doctor doesn’t need to do a pap that doesn’t mean you don’t need an exam. You should return yearly for a complete well-woman exam to access the health of the entire (not just cervix) female genital tract.
So what are the recommendations for receiving a pap smear?
Women 21-29 years of age should have a pap every 3 years
Women 30-65 years of age should have a pap every 5 years
Women over 65 may stop having paps unless they have had cervical cancer or moderately or severely abnormal cells found on a biopsy of the cervix.
It is also important to note that many doctors disagree with these recommendations and feel paps should be performed more frequently. Ask your doctor what he/she thinks is right for you.
Again, please remember whether or not you are in need of a pap test you need to get your yearly exam! Taking care of you is our top priority, and it should be yours too! And don’t forget–most insurance providers cover these preventive services annually.
Dr. Todd Billett has been named one of America’s Top Obstetricians and Gynecologists by the Consumer’s Research Council of America. Dr. Billet sees patients at VPFW’s office in the Henrico Doctor’s Hospital Professional Building, West Creek Medical Park in Short Pump, and Prince George/Colonial Heights Office.