Why do women need PAP smears?

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It was recently brought to my attention that explaining the basics surrounding PAP smears might be helpful. So here I go. Before the advent of the PAP smear, which is when the cells of the cervix are sampled during a GYN speculum exam and reviewed under a microscope for abnormalities, many women died of cervical cancer. That is why women need PAP smears. The PAP smear is a screening tool for cervical cancer. A PAP smear will also detect cervical pre cancer, otherwise known as cervical dysplasia. High grade cervical dysplasia can lead to cervical cancer, and it a treatable condition. Therefore, women will never progress to cervical cancer, if dysplasia is detected and treated. The cause of cervical dysplasia is due to an infection by the Human Papilloma Virus (HPV), a sexually transmitted virus that is ubiquitous and invisible to the naked eye. HPV is also the virus that causes genital warts. That is one of the many reasons why condoms are useful, as they protect against the transmission of the human papilloma virus.

When should they get their first one?
Women do not need to get a PAP smear before the age of 21, even if they are sexually active. The reasoning here is that even if younger women get exposed to the human papilloma virus, their immune system will usually clear the infection over time. There are new guidelines for how often women should get PAP smears. It used to be every year, as part of a GYN exam. Now the interval is every 3-5 years along with HPV testing, as long as the previous several tests have been normal.

And their last?
Once women turn 65 and have a history of several recent normal PAP smears/HPV testing, the risk of getting cervical cancer approaches zero. I always like to congratulate my PAP smear graduates!

What does an abnormal PAP smear mean?
So what does it mean if you are told that you have an abnormal PAP smear? That depends on a few factors. Does the report say you have atypical cells, low grade dysplasia or moderate to severe dysplasia? Is your HPV test normal or do you have a high risk type of virus? It can turn out to be nothing at all, since PAP smears are not perfect screening tests or it can turn out to be something that requires further investigation. That test is called a colposcopy, which is a high powered microscopic view of the cervix done right in the office. If any area looks abnormal, biopsies are taken and sent to a pathology lab for evaluation. If the result is moderate to severe dysplasia, a cervical procedure called a LEEP excision will usually remove all the abnormal cells. With some close follow up over the year, most women will return to their previous normal status.

Now go get your PAP smears!

Tara Allmen, MD Credentials:
– Board Certified Gynecologist and Nationally Certified Menopause Practitioner
– New York City’s Leading Expert In Menopause
– President, North American Menopause Society Foundation
– Fellow of the American College of Obstetrics and Gynecology
– New York City’s Top Gynecologist, 2015
– Five Star Rating From Doctor’s Choice Awards
– Five Star Rating From HealthGrades

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