When was your last pap test

Diana Jones, OB/GYN, Women’s Health Nurse Practitioner

BSU Women’s Center

When do I need to see an Ob/Gyn?
Have you ever been to an Obstetrician / Gynecologist or OB / Gyn for a pelvic exam and Pap test? If your answer is "No," and you are 21 or older, pick up your phone today and make an appointment with a local Ob/Gyn , a family physician, or a family planning clinic in your area. However, if your answer is "Yes," then how long has it been since your last Pap test and pelvic exam? If you haven't been seen for a year or longer it's time to make an appointment.

When do women need pelvic exams?
Teenage girls should see a provider between the ages of 13 to 15. While pelvic exams are rarely required during this first visit, this visit helps to establish a relationship with the provider of your choice and to go over your medical and sexual history (even if you have not had sexual intercourse.) This is a good time to ask questions about sexually transmitted infections, contraceptives, Calcium and bone health, doing the breast self exam, and about the new HPV vaccine.

The American College of Obstetricians and Gynecologists or ACOG recommends Pap testing begin within three years of sexual intercourse, or by age 21. Even young women who have not become sexually active need to visit a provider or Ob/Gyn by age 21. ACOG further recommends yearly Pap tests until age 30 when healthy women who have had a least three normal Pap tests in a row may begin to have the test every two to three years, or as often as their provider suggests.

In 2002, the American Cancer Society released new cervical cancer early detection guidelines, which state cervical screening should be done every year with regular Pap tests or every two years using liquid-based Pap tests. At of after age 30, women who have had three normal test results in a row may get screened every two to three years. A provider may suggest getting the test more often if a woman has certain risk factors such as HIV, herpes, a history of abnormal paps, a weakened immune system, etc.

It is not uncommon for providers to disagree somewhat as to the frequency of having Pap testing. This may come from their background training, personal experiences, or the woman's personal and family history. It is important to understand not all providers do things exactly the same. The important thing is to promote quality health care, flexibility for women and their health care providers, and for the woman to be able to discuss with her provider the benefits, risks, and limitations of cervical cancer screening (Pap tests).

What if I'm having problems with an unusual and/ or persistent vaginal discharge, bleeding between periods, or bleeding after sexual intercourse?
While a yearly Pap test is not always necessary after age 30, all women still require an annual pelvic exam to check for any other changes or infections. If you've had an HPV test that was negative that doesn't mean you don't need to have a yearly pelvic exam. The ACOG established these guidelines with full knowledge that HPV causes cervical cancer. Also, with each new sexual partner your risk of getting HPV increases by 15 %. This means having multiple sex partners raises your risk of HPV substantially. According to ACOG guidelines for Pap testing women diagnosed with HIV or other diseases or conditions that lower immunity should continue having annual Pap tests after age 30.

FACT: The greatest single reason for the occurrence of cervical cancer is not having Pap tests according to recommended guidelines. The majority of women diagnosed with cervical cancer have not had a Pap test in five or more years. Sadly, these women are usually at an advanced stage of cancer when they received their diagnosis.

Diana Jones, is a OB/GYN and Women’s Health Nurse Practitioner at the BSU Women’s Center, managed by Cardinal Health System. For more information contact info@chsmail.org.

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