Apparently You Don’t Need an Annual Pap Smear Anymore


I thought I needed to do this uncomfortable procedure once a year until a doctor informed me otherwise.

This article was originally published at Zelda Lily

I hate Pap smears. Absolutely hate
them. Not just because of their invasive nature, but because I have
what doctors like to call a "sensitive cervix." While most people just
feel some pressure when that awful metal contraption clamps down on
them, I feel pain. Intense pain. And I feel even more pain when they go
in there with that stupid broom thing. The doctors and nurses all
assure me that there is nothing wrong with me; I’m just one of those
rare souls who’s especially sensitive cervically. I had my annual Pap
smear nearly 12 hours ago. I’m still a little sore.

My appointment was with a brand new doctor, since I just moved here
to Seattle a year ago. As I sat whimpering in her office and warning
her to be gentle and quick, she said, "Well, dear, after this one,
you’ve graduated to the next level of Pap smear. You only need it every
two years now." I asked her to repeat that. She explained that they
know a lot more about cervical cancer these days, and that it’s caused
almost exclusively by the HPV virus (typically transmitted sexually),
and apparently once you’re over the age of 26, you’re good to go with
screenings further between. Her explanation for this was that your risk
of HPV increases with the number of sexual partners you have. As women
get older, she said, they have fewer sexual partners, so their risk of
infection is lesser. "If you only have sex with one guy every one or
two years, you’re fine just getting tested every couple of years."

I was a little offended by this. Like, I’d already told her I didn’t have a boyfriend, but do I look
like someone who only gets laid once every two years? (No.) I mean, I’m
delighted at the prospect of not going in for this shit every year,
but, especially after British reality star Jade Goody died of cervical
cancer last month, I’m hyper-aware of it and I want to make sure I’m
protecting my health — even if it involves some extreme discomfort. So
I did a little research of my own when I got home.

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I found a fascinating article published by the New York Times
earlier this month. It discusses a new DNA test that does a better —
and earlier — job of detecting HPV, and it will likely replace the Pap
smear. Not just that, but it could likely mean you only have to get
your cervix swabbed once every 3, 5 or even 10 years, depending on
which expert is asked. GOOD NEWS FOR ME!

Their optimism is based on an eight-year study of
130,000 women in India financed by the Bill and Melinda Gates
Foundation and published last week in The New England Journal of
Medicine. It is the first to show that a single screening with the DNA
test beats all other methods at preventing advanced cancer and death.

The Indian study, begun in 1999, divided 131,746 healthy women ages
30 to 59 from 497 villages into four groups. One group, the control,
got typical rural clinic care: advice to go to a hospital if they
wanted screening. The second got Pap smears, the third got
flashlight-vinegar visualization, and the fourth got a DNA test, then
made by Digene, which is now owned by Qiagen. The company did not pay
for or donate to the study, its authors said.

After eight years, the visualization group had about the same rates
of advanced cancer and death as the control group. The Pap-smear group
had about three-fourths the rates, and the DNA test had about half.

Significantly, none of the women who were negative on their DNA test
died of cervical cancer. “So if you have a negative test, you’re good
to go for several years,” Dr. Blumenthal said.

The study’s chief author, Dr. Rengaswamy Sankaranarayanan of the
International Agency for Research on Cancer in Lyon, France, said,
“With this test, you could start screening women at 30 and do it once
every 10 years.”

There’s some hesitancy to adopt less frequent screening in the U.S.,
because doctors use the annual Pap smears as a way to get women into
their office to address a wide range of health issues. But get this: Since
1987, the cancer society and the American College of Obstetricians and
Gynecologists have recommended Pap smears only every three years after
initial negative ones.
That’s right! They’ve been saying for over
TWENTY YEARS that we could come in less frequently for that horrid
procedure. But they don’t want us to know that, because they want our
butts in their office every year to get our tits checked and our uterus
pushed around.

Says Debbie Saslow, director of gynecologic cancer for the American
Cancer Society, “The average gynecologist, especially the older ones,
says, ‘Women come in for their Pap smear, and that’s how we get them in
here to get other care.’ We’re totally overscreening, but when you’ve
been telling everyone for 40 years to get an annual Pap smear, it’s
hard to change.”

Obviously, you should get your butt (and cervix!) to a gynecologist any time you
have concerns about your body, but this news absolutely delights me,
and I’m annoyed that I wasn’t told about it earlier, especially since
my past doctors knew how much the procedure traumatized me. But I
always felt that if I didn’t get my annual Pap, I was putting my health
at risk. So not only does this take a huge annual burden off my
shoulders, but the new DNA testing offers a lot of hope to women in
third-world countries, where cervical cancer kills more than 250,000
women a year — that number is just 4000 in the U.S.

Medical science, my cervix salutes you. Now back off.

Topics and Tags:

annual exams, obgyn, pap smears

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