When should I get a pap test? How often?

There are new recommendations for pap tests from the American Cancer Society (ACS) and the American Congress of Obstetricians and Gynecologists (ACOG.)  It is now suggested that most young women have the first pap test at age 21 years.  The research shows that the young woman’s immune system will clear any of the viruses that lead to cervical cancer prior to this age.  If her pap test is negative, the American Cancer Society says that a woman can wait and do the cancer screening test every 2 years.  If a woman is 30 and has had 3 negative or normal pap screening tests in a row, ACS and ACOG believe she could even do the cancer screening test every 3 years.

Of course, some women have expressed the concern that they do not want to wait 2 to 3 years to find out if they have a problem and would rather get the pap test every year when they come in for their annual well woman check-up.

If the pap test is in that gray area, normal but signs of a high risk HPV virus, the woman should definitely have a repeat pap in at least one year if not in 6 months.

 

If there is an abnormal pap test or a pap test that says atypia and high risk HPV, the next step is to look at the area with a colposcope.  The colposcope is a just a microscope on a stand.

The doctor will look through the colposcope at the cervix after wiping off the mucus present.  If there is anything suspicious, she will take a tiny pinch of that area to send to the lab.  She’ll finish by gently scraping a few loose cells just inside the cervix to send to the lab as well.

Once the results of the biopsies come back the doctor will recommend treatment.

If there are just mild changes or just atypia, she’ll recommend repeat pap tests every few months to watch the cervix clear the changes from the virus and to make sure the problem does not go any further.

If there are any pre-cancerous changes she will suggest numbing the cervix and scraping off the abnormal outer layer.

Pre-cancerous changes of the cervix can also be treated by freezing the outer layers of the cervix.

Any more advanced abnormality of the cervix is treated with surgery and/or radiation therapy.

 

What does it mean when my pap test shows HPV?  What’s the difference between an abnormal pap and HPV?

Part 1

The Pap test has been used since the early twentieth century to look for cancer of the cervix.  Over the years the original test has been refined and now this test looks for cancer of the cervix, pre-cancer of the cervix and sexually transmitted diseases.

HPV or human papilloma virus is a common virus that the Pap test can pick up.  There are about 100 different HPVs. The low risk virus group causes the warts sometimes seen on the outside of the genitals.  The high risk virus group can lead to pre-cancer and later, if not treated, cancer.

Research guesses that 80% of the general sexually active population in the United States carries at least one of these viruses.  That would include, moms and dads, and grandparents who of course are moms and dads and grandparents because at some time they were sexually active.

The Pap test is normal if there is no sign of pre-cancer –dysplasia, and no signs of cancer.

An abnormal pap test may have dysplasia, cancer, or neither and just say atypia.  Atypia just means “look a little closer, there may be something there.”

 

 

How do you get through your first pelvic exam?

The first thing is to realize that everyone is nervous at a pelvic exam.  So a few days before your visit, begin touching the outside of the vagina while bathing.  This will help desensitize that area.  Use a mirror to help locate the vaginal opening.  The vaginal opening is the middle opening below the urethra, where the urine comes out, and above the anus.  Insert your clean finger or a small tampon slowly into the opening, stopping several times after a few seconds to get used to the sensation before proceeding further.

All of the nerve endings are just at the vaginal opening.  Once you get past that point, there is little sensation inside the vaginal canal. You won’t feel the finger or tampon inside the walls of the vagina.  You can place your finger gently all the way inside until you reach something that feels like the tip of your nose.  This is the cervix.  You won’t hurt or damage yourself.

So if you practice this a couple of times a day for a few days before your first pelvic exam, you will be much more comfortable and at ease and get through the few-minutes procedure with little trouble.