Pap Smears have been Replaced with HPV Testing.

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There are many benefits to having an annual GYN exam that includes a Pap Smear.

Due to a new trend in medicine that believes that less is more, the Pap Smear has been benched in lieu of a more specific test, the HPV test.  The American Cancer Society

now recommends that women with a cervix be tested every 5 years after age 25, until age 65.  This is a change from the most recent guidelines that recommended Pap smears for women over 21.  In that old recommendation, the HPV test was only done if the Pap smear was abnormal. Both tests are done by a physician or Nurse Practitioner by doing a vaginal swab at the time of the pelvic exam.  This test must go to the lab to be processed and there is a lag time for both tests before results come to the physician’s office. There is another lag before patients are notified of an abnormal test.  While we used them, pap smears were somewhat inaccurate, and often had to be followed by other tests to document a real problem, and many times women were worried by pap tests that just told them that they needed another test.

Pap smears were a new innovation in 1915 that saved millions of women’s lives from cervical cancer.  Cervical cancer is the result of an HPV viral infection which is sexually transmitted, in fact it is the most common sexually transmitted disease in the US.   The Pap smear detects abnormal cells that have been infected with HPV virus.  The HPV test actually detects the viral infection itself.  Thankfully HPV infection often disappears on its own from the immune system killing the virus.  The infection with HPV doesn’t just disappear in women who suppress their immune system with smoking, alcohol excess, some medications, environmental toxins and poor diet. The virus can progress and become pre-cancer and then cancer in these patients.  Another factor that affects whether HPV can disappear without treatment, is the strain of HPV.  Some viral types are more likely to cause cancer than others.

In the past decade, American doctors began recommending a vaccine against HPV to get a head start on wiping out HPV infections all together, and therefore cervical cancer by immunizing children before they become sexually active.  This vaccine is also given to female teenagers who are already sexually active.  The HPV immunization is a series of three injections that prevent HPV and or prevent the progression of HPV’s progressing into cervical cancer.

After years of preventing HPV infection from being contracted in the first place with the immunization, the American Cancer Society is changing its guidelines for the use of pap smears to decrease the number of cervical tests and to use a more specific test, the HPV test, that reports the presence of HPV as well as the viral type which specifies how aggressive the HPV virus is, and how soon it will cause cancer. The ACC believes that this guideline will reduce cervical cancers by 13%, and 7% of Cervical Cancer deaths.

The ACC thinks this plan will lessen the occurrence of cervical cancer, cervical cancer deaths and also decrease the number of unnecessary cervical biopsies and hysterectomies.

Over the years our treatment has become more specific and less tedious, and diagnosis more specific than ever in the past: we have gone from a Pap smear yearly by the GYN physician visit starting at age 18 every year, to beginning HPV tests at age 25 every 5 years until 65.

It is important to note that a yearly gyn visit is still recommended for adult women because at that visit a breast exam and a pelvic exam is done to detect ovarian cysts and tumors, fibroids, and to evaluate uterine bleeding, birth control, discuss sexual questions and emotional problems.  Gynecologists are trained in all types of female diseases and are integral to the health of women of every age.

There is a vaccine for HPV that will prevent you or your daughter from getting HPV and cervical cancer, but only if you get it!. You should also know that men can be carriers but rarely develop cancer of the penis, prostate or bladder themselves. If you get both your sons and daughters immunized with the vaccine, then they will not be at risk for having or transmitting this disease throughout their lives.  It is in this way we can wipe out a cancer that has been around since the beginning of time.


This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author.

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