Pap Test Guidelines

The Pap test, also known as a Pap smear, is a test used to identify pre-cancerous cells on a woman’s cervix. After 1945, when the American Cancer Society (ACS) began recommending women have Pap tests to detect cervical cancer in its earliest stages, the number of deaths from cervical cancer dropped by approximately 74 percent between 1955 and 1992, according to the E Health MD website. Pap tests used to be recommended for women annually; however, the American College of Obstetricians and Gynecologists (ACOG) has recently altered its guidelines for when and how often women should have the test done.

History

The Pap test is named after its inventor, George Papanicolau, M.D. According to the American Medical Association (AMA), Papanicolau first discovered that vaginal smears could be used to catch cancerous cervical cells in their early stages during the mid-1920s, but it wasn’t until he published his findings in the “American Journal of Obstetrics and Gynecology” in 1941 that the medical establishment became aware that the test had tremendous cancer-preventing value. After the Pap test became an annual staple of the life of modern women, cervical cancer rates dropped dramatically.

Process

The Pap test involves collecting a small sample of cells from the surface of the cervix and the tissue immediately around the cervix. A speculum–a metal or plastic piece of medical equipment–is gently inserted into the vagina and used to allow a physician to obtain the cervical cell sample. The cells are prepared for microscopic evaluation, then closely examined for cellular abnormalities that may signal the beginning of cervical cancer.

Women are recommended to not douche, have sexual intercourse or use a tampon, birth control foam or vaginal cream for two days before a Pap test since these can interfere with the test results. Women also should not have a Pap test performed when they are on the menstrual cycle.

Guidelines

In late November 2009, the ACOG announced that recent research indicates that its previous Pap test recommendation for women–that all women over 21 or within three years of first becoming sexually active, whichever came first–should be revised. According to the new Pap test guidelines, all women should receive their first test at 21 years of age, regardless of when they became sexually active. Until the age of 30, women should have a Pap test every two years. If women have three normal Pap tests in a row, they need only be tested every three years after they pass 40. They can stop being tested altogether after they reach 65.

Significance

According to the Mayo Clinic, the reason for the changes in the Pap test guidelines are based on research indicating that young women are not at high risk for developing cervical cancer under the age of 21. In fact, the “U.S. News & World Report” indicates that treatments for possibly pre-cancerous cells in young women–cells that are now thought not to increase a young woman’s chance of cervical cancer–can increase her chances of delivering babies prematurely later in life.

Controversy

The alteration in the Pap test guidelines, though supported by most obstetricians and gynecologists, initially caused a good deal of concern in some women’s health advocacy groups, especially–according to a November 2009 article in the “U.S. News & World Report”–since the changes were announced only days after the U.S. Preventative Services Task Force announced alterations in its recommendations for when women should begin having mammograms and how often those mammograms should be conducted. Since that time, however, physicians and women’s groups agree that the new Pap test guidelines are supported by cervical cancer prevention research.