The Doctor's Corner

Hello and Happy New Year! I am considering this year to be “lucky 13”!  Many patients may have already heard my “Pap story” at a recent visit, but I want to tell it again and reach a wider audience.  The Pap smear is a screen for cervical cancer. It is obtained by using a soft brush to collect cells from the cervix. These cells are then fixed in a vial of liquid, and sent to the lab for interpretation. For some time now, Pap testing intervals have been stuck in the 1960’s. Pap tests were new then, and they didn’t have a track record. The annual interval for testing was chosen arbitrarily, but was probably appropriate then, given the status of lab technology at that time. Now, however, lab technology has advanced, and Pap results are quite reliable and predictive. We have several decades of data on the performance of the Pap test, which is quite good. And, the availability a test for HPV, the virus that causes cervical pre-cancer and cancer, has made a big difference in our ability to predict potential problems. The HPV test is routinely done with the Pap in women over 30, a combination known as “co-testing”. 

So, in the interest of modernizing the Pap interval, we have new guidelines for how often to send the test. As with everything in medicine, there is never a “one size fits everyone” approach. But, if you have normal results, a Pap will be sent less often than annually. If you are under 30 years old, I will be using an every-other-year schedule. If you are 30 or older, an every-third-year schedule will be in order. I do want to be clear on one thing, though: we still recommend an annual check-up for most patients. There is a lot more to your “annual” than just the Pap test! We will be keeping track for you and sending the Pap test at appropriate intervals, which can always be modified according to individual circumstances.   Since the likelihood of a real problem within 5 years of a normal Pap result is very low, I am comfortable with an every 2 to 3 year schedule for Pap tests.

Mammogram intervals will stay the same. Current recommendations are to start offering annual mammography at age 40. 

This year I am resolving to update this column more regularly, so I’ll leave it at this one topic for now. Be sure to access prior topics via this page and let me know if you have ideas for future discussion!

Until next time,
Lisa L. Savage, M.D.