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Ask the Doctors – When can I stop having an annual Pap smear every year?

Dear Doctors: What are the updated guidelines for cervical cancer screening? I’m 62 and want to know what is recommended going forward. Is an annual pelvic exam still necessary if a Pap smear isn’t being done? And have guidelines have changed for teens and 20-somethings?

Dr. Elizabeth Ko and Dr. Eve Glazier
Dr. Elizabeth Ko and Dr. Eve Glazier

You’ve asked a lot of excellent questions that will have a broad spectrum of readers interested. And you’re right, screening guidelines are changing.

A Pap test, also called a Pap smear, is used to screen for cervical cancer. It’s a routine procedure that checks for cell changes on the cervix, which is the opening of the uterus. The test looks for abnormal cells that might become cervical cancer if not treated appropriately.

During a Pap smear, cells and mucous from the cervix are collected and then examined under a microscope. Cells from the same sample can also be used for an HPV test, to check for presence of the human papillomavirus, the most common sexually transmitted infection. Women with HPV have a higher risk of developing cervical cancer than women who do not have HPV.

Guidelines from the American Cancer Society as well as the American Congress of Obstetricians and Gynecologists recommend that all women should begin cervical cancer screening at age 21. Between 21 and 29, a Pap smear should be performed every three years. In this age group, HPV testing should only be used if a Pap smear returns with abnormal cell results.

When a woman turns 30, the Pap smear should be used along with an HPV test. This co-testing should continue at five-year intervals until age 65.

For women at higher risk of cervical cancer, screenings need to be performed more frequently. The most important risk factor for cervical cancer is the presence of human papillomavirus, which is actually a group of more than 150 related viruses. Certain types of HPV, sometimes referred to as high-risk, have been strongly linked to cervical cancer.

Additional risk factors for cervical cancer include smoking, having a weakened immune system due to HIV or taking immunesuppressive drugs, being infected with chlamydia, a family history of cervical cancer, and exposure to DES, a hormonal drug given to some women between 1940 and 1971. If any of these risk factors apply to you, talk to your physician or gynecologist about whether you should increase the frequency of screening

At age 62, you’re on track for at least one more round of co-testing with both a Pap smear and an HPV test. At age 65, the guidelines change again.

Women 65 and older who have had regular screenings for the previous 10 years, and whose tests have not turned up any abnormalities in the previous 20 years, can stop Pap smears.

As for pelvic exams, that’s another nexus of change. The U.S. Preventive Services Task Force has recently declined to say that pelvic exams are necessary. Pelvic exams may have diagnostic value for detecting conditions like genital herpes, ovarian cysts, uterine fibroids, genital warts, and others. We recommend that you discuss your options with your gynecologist or primary care physician.


Eve Glazier, MD., MBA, and Elizabeth Ko, MD., are internists at UCLA Health. Dr. Glazier is an associate professor of medicine; Dr. Ko is an assistant professor of medicine.

Ask the Doctors is a syndicated column first published by UExpress syndicate.


To make a long story short I am a 4 time cancer survivor.. I was told it would return with 1-2 years as I had just had a sarcoma on my ribs caused by Radiation 10 years prior to prevent the cancer from returning.
I was advised to do scans every three months so they cold pick up the cancer that was certain to appear in my lungs,
following the removal of the sarcoma.
I had always said I would do no more drugs after intuitively knowing it was too hard on my body.And I certainly did not want any more radiation. So I told my Doctors, I was putting my life in the hands of my Divine Physician and left to live well as a long as I had.
Well my Divine Physician led me to the Plant Based world and the Doctors who are truly knowledgable about our bodies and what they thrive on. One of the Docs I follow is Dr Greger who has a web site "nutrtionalfacts.org" where he publishes (for free) the latest proven science on all matter concerning our bodies.
Since I am now 10 years out from my last cancer and set free from ailments I had before going plant based like arthritis, rosacea, hot flashes, and blessed with great energy at 78. i have not a complaint.
One can go to Dr Greger's website and look up just about any questions concerning the body. I would refer you to it to look up Choline and see what research has to say. You might find that very interesting.
Thank you, I hope this is helpful.
Oh the two big influences 10 years ago leading me to this way of eating: I read The China Study and the saw Forks over Knives followed by a luncheon with 30 women who all brought a dish plant based and oil free( three we're clearing their arteries due to heart issues) and I loved everything. And I still do.
Sincerely
Allie

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