Recommendations for Cervical Cancer Screening

Benefit vs Risk

Annual cervical screening is thought to lead to a large number of unnecessary procedures and treatments. The prevalence of the virus associated with cervical cancers is high, but the cervical cells will likely return to normal within 1 to 2 years as your body is capable of fighting off the infection. The small fraction of cervical lesions that do not regress will, on average, require many years to progress to cancer. Identifying and treating abnormal cells that will likely return to normal on their own does not provide a benefit great enough to outweigh the harm of treatment.

These harms may include anxiety associated with a “positive” cancer screening test, potential stigmatization from the diagnosis of a sexually transmitted infection, discomfort from additional diagnostic and treatment procedures, bleeding from treatment, and, longer term, an increased risk of pregnancy complications such as preterm delivery in women previously treated with excisional procedures for precancerous lesions, or difficulty getting pregnant due to narrowing from scar tissue around the cervical opening.

Current PAP recommendations:

• Beginning at age 21 regardless of sexual history.  HPV vaccine does not change screening recommendations.
• Age 21-29 screening every 3 years
• Age 30-65 screening every 5 years if negative for HPV and not high risk
• After age 65 if no recent abnormal PAP can discontinue screening

Note: the new guidelines are for women at average risk. More frequent testing may be appropriate for women with conditions that place them at an increased risk of cervical cancer, such as immunocompromised or human immunodeficiency virus (HIV) infection.

Remember you still need to go in every year for your wellness exam which includes a full physical exam with both breast and pelvic exam.  Wellness exams may also include other screening recommendations based on age and/or routine blood work.  If you’re due for your physical and want a comfortable and relaxed environment, schedule your next wellness exam with Dr. Schulz.  She offers routine exams, testing for sexually transmitted infections, contraception, breast and pelvic health counseling, hormone balancing and replacement, and natural approaches for optimizing fertility and prenatal care.

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