Screening for Cervical Cancer

Pap smears are tests that screen for precancerous and cancerous changes of the cervix.

What causes abnormal pap smears?
Abnormal pap smears are caused by Human Papilloma Virus (HPV). HPV is spread by sexual contact but is the “common cold” of sexually transmitted infections. Over 80% of women will test positive for HPV at some point during their lifetime and the infection can be from any partner in her lifetime. There is no remedy for HPV; but your immune system will work to suppress the virus. Therefore there will be times when there is no physical evidence of the virus.

How often do I need a pap smear?
Pap smears are offered to all women between ages of 21-65.
• Women aged 21-29 should have pap smears done every 3 years.
• Women aged 30-65 should have a pap and an HPV (“co-testing”) every 5 years. An alternative is to have a pap test alone every 3 years.
• Women should stop having pap smears after age 65 years if they do not have a history of moderate or severe abnormal paps or cancer AND have had either 3 normal pap tests or 2 negative co-test results within the row within the last 10 years. The most recent test needs to be within the past 5 years.
• Women with a history of cervical cancer, HIV, weakened immune system, DES exposure before birth should not follow these routine guidelines.

What is co-testing?
Co-testing is when your doctor does a routine pap smear but also tests you for the HPV virus. If both pap and HPV test are normal, the likelihood of abnormal pap smears is much less over the next 4-6 years. Women under the age of 30 should not get HPV testing as infection is common and frequently resolves.
To find out if HPV testing is covered by your insurance, you can call your insurance provider and give them the following information.
CPT: 87621
ICD-9: V73.81 HPV screening ICD-10: Z11.51 Encounter for Screening for HPV
Or go to the following website and they will contact your insurance company for you.
www.thehpvtest.com

Why don’t I need a pap smear every year anymore?
Studies have shown there is no real advantage to yearly paps over every 3 years. More frequent pap smears are more likely to result in more procedures and tests that are unnecessary. However, annual examinations with your doctor is still recommended.

So can I come in only every 3 years?
No, you still need to be seen every year. Your annual gynecologic exam is not just for cervical cancer screening. It is important for all aspects of your health including contraception, pregnancy planning, breast problems, period problems etc.

What if I have had a hysterectomy?
If you have had a hysterectomy, you may still need cervical cancer screening with pap smears. You will need to talk with your doctor whether you still need to have pap smears.

What happens if I have an abnormal pap smear?
Most abnormal pap smears are followed by a colposcopy. A colposcopy is an office procedure where we take a closer look at the cervix with a microscope and typically take a few biopsies. Based on these results, you may need further treatment but most often, you just need to follow up for more frequent pap smears. Your doctor will determine the best treatment course for you.

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