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When to Get a Pap Test
I recently saw my gynecologist for an annual checkup. As I was getting dressed afterwards, I realized that she hadn’t taken a swab sample. Usually during a pelvic exam, the doctor will insert a small brush or stick into the vagina and gently rub it against the cervix to collect a cell sample. This is called a Pap test. Your health care provider does the test to check for abnormal or pre-cancerous cells on the cervix.
I had always assumed that a Pap test was a routine part of any gynecological checkup. When I asked my doctor about it, she explained that the recommended guidelines for Pap testing had recently been revised by the American Congress of Obstetricians and Gynecologists (ACOG). I was very surprised, as the new guidelines called for less frequent testing, and I had always thought that the problem was that not enough people were getting tested regularly.
I went home and did some research on the new guidelines. I found that ACOG once recommended that girls get Pap tests three years after first engaging in sexual intercourse, but no later than age 21. But now they’ve changed the guidelines. And, the information about the new guidelines was more confusing rather than clarifying, so I spoke to Caroline Hoke, M.D., an obstetrician-gynecologist for Planned Parenthood of Illinois.
Sex, Etc.: First, what are the new guidelines?
Dr. Hoke: The new ACOG guidelines state that a first Pap shouldn’t occur until 21 years of age, regardless of age at first intercourse. And after that every two years from 21 to 29, as long as a patient does not have HIV, is not immuno-compromised [meaning she doesn’t have an immune system that has been impaired, usually due to illness], or does not have a history of Pap test results that show severe cell abnormalities.
Sex, Etc.: Do you think the guidelines discourage young women from seeking tests from their gynecologists?
Dr. Hoke: The message is still see your gynecologist yearly for family planning and screening for sexually transmitted diseases (STDs). I think most adolescents don’t know the difference between a Pap test, STD screening or pelvic exams, thus education will be critical.
Sex, Etc.: What about the fact that many STDs don’t always show symptoms? Do you think this, coupled with the new guidelines, may also cause young women to think they don’t need to get tested or see a gynecologist?
Dr. Hoke: We must educate adolescents that these new guidelines do not mean don’t see your health care provider on a yearly basis for STD screening or family planning. I find that many young women have symptoms of some sort which causes them to make an appointment with their health care provider. Many times, the symptoms are normal, self-limiting issues and not related to an STD necessarily; thus, education and reassurance are the cornerstones in these visits. So despite the new Pap guidelines, I think and hope patients will still want to make annual appointments. The media can play a large role in making sure teens understand that Pap tests do not screen for STDs, so teens must still see their health care provider for yearly STD screening.
Sex, Etc.: What are the potential benefits of the new guidelines?
Dr. Hoke: The main benefit is we can decrease the anxiety associated with needing further testing for false-positive Pap results. [A “false-positive result” is a test results that says there are abnormal cells on the cervix when there really aren’t any.] It is common in teens to see some mild inflammation of the cervix that some gynecologist may follow up on unnecessarily. Not only is this a waste of resources, but it can also cause a lot of worry in an adolescent patient and her family.
Sex, Etc.: What do you wish all young women knew about their sexual health, regardless of the guidelines?
Dr. Hoke: Young women need to learn to respect, love and understand their bodies, which will create higher self esteem and hopefully minimize risk-taking behaviors. Young women need to know they can have control of their sexual health and make good choices for themselves. Prevention is the key, and young women need to have the education and resources available for prevention of STDs or pregnancy, or both.
I came away from speaking with Dr. Hoke with a new perspective on the revised Pap test guidelines. I realized that I had not stopped to consider just how different STD testing and Pap testing were, and also never considered that such frequent Pap testing could be wasteful and unnecessary. Thankfully, Pap testing is now one thing we can relax about. However, STD testing should still be a regular part of our lives, regardless of our age.
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Contributor Alexx Engles lives in Illinois.
