By Natalia Gurevich, SWHR Communications Intern
Many women have a Judy Bloom-esque "first period" story, but has anyone ever told you their "first pap smear" story?
The Pap smear is a milestone rarely discussed and largely disregarded in conversation and popular culture. When women make their first visit to the gynecologist, there is little more than technical information to prepare with. We sit in a sterile office, wearing a paper gown, counting the ceiling tiles and waiting for the appointment to end. And yet, it's a visit we all have to make for a test critical to our sexual health.
A Pap smear (also called a Pap test) is a screening procedure for cervical cancer and is important for women to get when they turn 21. The test screens for the presence of precancerous or cancerous cells on the cervix, the opening of the uterus [1]. During the procedure, cells from the cervix are gently scraped away and then examined for abnormal growth.
In 2012, the U.S. Preventive Services Task Force (USPSTF) recommended women only start getting screened for cervical cancer at age 21. Other national organizations, including the American Cancer Society, the American College of Obstetricians and Gynecologists, Society of Gynecologic Oncology (SGO) and the American Society for Colposcopy and Cervical Pathology, also recommend the same guideline, but with some amendments, such as allowing for more flexibility [4]. Some healthcare providers urge women to begin testing when they become sexually active rather than testing based on age [2].
There is also a slight discrepancy in how often women should be screened, whether an annual visit is necessary, or if every three years is sufficient [4]. Many national health organizations consider annual visits excessive, and can decrease the effectiveness of the screening. However, some organizations see annual visits as an opportunity for women to discuss and go over other potential health risks and questions [4]. According to the American Academy of Family Physicians, the test should be conducted between the ages of 21 and 65, beginning at every three years, and if a woman tests normally three consecutive times, she can then choose to get tested every five years [5].
Pap tests are increasingly important as Human papillomavirus (HPV), a virus that can cause warts, becomes more widespread, especially in women under the age of 25. The majority of those affected with HPV are in their late teens and early twenties [6]. There are over 100 different types of HPV - 40 of those are sexually transmitted, and two (HPV 16 and 18), can cause cervical cancer [1]. The Pap smear doesn't test for HPV specifically, but it tests for cellular changes and abnormalities that HPV can cause.
According to the Centers for Disease Control and Prevention (CDC), 79 million Americans are infected with HPV. About 14 million people become newly infected each year. HPV is so common that most sexually active women and men will get at least one type of HPV at some point in their lives [3]. The majority of HPV strains are asymptomatic, and the few strains that do present symptoms mainly only present themselves in women [3].
Pap smears, cervical cancer screenings, and HPV tests are key methods for assessing a woman's risk for HPV and cervical cancer. The good news is the prevalence of cancer-causing HPV strains has been decreasing since the introduction of the three-shot vaccine in 2006 [6]. But awareness is still essential in maintaining health.
The Society for Women's Health Research (SWHR®) offers more information about testing options on our website. If your 21st birthday is coming up, by all means, indulge in a margarita (or two), but be sure to contact your healthcare provider with any questions you may have about this rite of passage: the Pap test.
References:
1. http://www.healthline.com/health/pap-smear#Overview1
2.http://www.cdc.gov/cancer/dcpc/research/articles/cervical-young-women.htm
3.https://www.cdc.gov/std/hpv/stdfact-hpv.htm
4.http://www.cdc.gov/cancer/cervical/pdf/guidelines.pdf
5.http://www.choosingwisely.org/patient-resources/pap-tests/
6.https://www.cdc.gov/media/releases/2013/p0619-hpv-vaccinations.html