New national Pap Smear guidelines have been revised by the American College of Obstetricians and Gynecologists Committee (ACOG) to commence at age 21, regardless of the first age of intercourse. Prior, we were screening for cervical cancer within three years of first intercourse, or sooner depending on patient risk factors.
This has caused some confusion amongst patients and the staff. Patients often still come in asking for a pap earlier than age 21 (because that is what they are used to doing), and the staff is continuing to room these rather confused patients. Like with everything else, when shifting gears, it takes a period of transition and acclimation to new guidelines every time they are revised.
Why the delay in screening age, my patients often ask? For several reasons:
1. Studies show that screening prior to age 21 does not prevent enough cases of cervical cancer to warrant screening. Let’s face it, the pap is not a pleasant visit. We all dread it. Why place these helpless youngsters into an uncomfortable position year after year when it may not even prevent cervical cancer?
2. Cervical cancer is rare in this age group, and accounts for one to two cases per million women per year.
3. The risks of having procedures performed on the cervix in those less than age 21 may place them at risk of preterm labor later in life in pregnancy.
4. Most Human Papilloma Virus (HPV) infections, the main cause of cervical cancer, in women of this age group are transient and self-resolving.
5. Cervical cancer is a slow-growing cancer that takes years to develop, allowing ample time to be discovered after age 21.
There are a few exceptions, however, that may require screening prior to age 21 (which you should discuss with your personal physician):
• Those with a diagnosis of HIV.
• Those with a prior organ transplant.
• Those with a history of long-term steroid treatment.
• Those deemed higher risk by their personal physicians for any other reason.
Knowing all of this, I personally wouldn’t want a pap before I was 21 years old. Would you?
6 comments:
I wouldn't want one! But question... why all the push for the vaccine if the incidents of cervical cancer in that age group is so low? Another case of Big Pharma starting a scare to up their bottom line?
Gia
Gia's Spot, the vaccine is designed to be given early on (prior to age 26) so that it can prevent cervical cancer LATER in life :)
Thx for reading :)
Kindly,
Jill
I never even thought about getting a pap until in my twenties.
But I did have a vag exam at 17 because of a yeast infection. The Dr asked me if I was on the pill and I wasn't ..which surprised him because he said that could cause it.
Definitely not pleasant exam.
"The risks of having procedures performed on the cervix in those less than age 21 may place them at risk of preterm labor later in life in pregnancy."
I have a friend who had an abortion when she was 18. Then she didn't have her first child until she was 32 and her second one when she was 36.
She went into premature labor with her 1st one at 30 weeks and after a month in the neonatal unit he came home. Her Daughter was also premature labor ..36 or 37 weeks.
Is it the abortion that would've caused something with the cervix because she was so young? And why doesn't it matter over 21?
I never heard that before.
Also what is the prerequisite for the vaccine. Is that only if you are sexually active with multiple partners ..or is it the standard for all girls at a certain age?
Seaspray, what i was referring to in regards to "procedures on the cervix" are those procedures designed to treat "abnormal pap" results -- such as the LEEP (loop electrosurgical excision procedure), which carries a risk of producing an incompetent cervix (one that would remain more "open" during pregnancy and hence more risk for premature delivery). This does not include abortions.
As for the vaccine, ALL girls aged 11 to 26 can receive the HPV vaccine, independent of the number of partners, whether they are sexually active or not, or even if they have been infected with HPV prior.
Hope i answered your questions! :)
Jill
Thank you Dr Jill. :)
SeaSpray, you are more than welcome!
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