Recent news releases may have created some confusion about pap smear testing...when to start and at what time interval to repeat. For example, going from starting pap testing at age 18 years or sexual activity which ever comes first to age 21 and then every 2 to 3 years apart.Also, the newer protocols place more emphasis on the HPV virus than the cytology reading of the pap.
I am very concerned that the new recommendations are too lax and will miss the diagnosis of cervical and vaginal dysplasia (pre-cancer) therefore increasing the risk of a patient incurring invasive cervical cancer. About 4500 women die of cervical cancer in one year in the US and 99% of these are totally preventable with proper Pap and colposcopy screening if we use the more tried and proven protocols. With the newer recommendations, many more will have their fertility compromised based on later stage diagnoses.
Our approach is to individualize the risk for each person based on age, symptoms, # of sexual partners, prior pap results, HPV status and colposcopy findings and make recommendations based on the benefits of early detection and what makes sense. Then we can have a conversation, answer questions and have the woman herself make the best decision for her care.