Recent changes to the guidance on cervical cancer screening has extended the interval between tests. Women with no history of an abnormal test can go have three to five years between tests. As a result, a common refrain we hear in the office is ‘but I want to have a pap test every year’.
The Pap smear test is the most successful cancer screening technique in history. It was named after its inventor, Dr. George Nicholas Papanicolaou. In 1920, Dr. Papanicolaou began his study of vaginal cytology (the study of the microscopic appearance of cells). Over time, Dr. Papanicolaou discovered cancer cells in a smear from of the uterine cervix and that cervical cancer could be diagnosed by means of vaginal smear. At first, there was very little interest but eventually the information spread among ob-gyns.
The rest, as they say, is history. Cervical cancer has gone from the #1 cause of cancer death among women in 1928 to number 10.
Thanks Dr. Papanicolaou.
In the early 1980s HPV 16 and 18 were isolated and linked to cancer of the cervix. Research continued and a decade later scientists had enough evidence to assert HPV as the cause of cervical cancer. Today HPV testing is one of the tools used to screen for cervical cancer and a vaccine against some types of HPV is available for young women and men to prevent infection.
As a result of these decades of research, we now know that Human Papilloma Virus causes cancer of the cervix. We know that the virus is sexually transmitted. We have information about the virus behavior–it acts slowly and is cleared by the immune system in most women and can test for it. We have a vaccine to prevent infection. All these advances in scientific knowledge were used to update the decades old recommendations for how often a woman should get a pap smear.
But wait. There’s more.
The pap test only screens for cancer of the cervix and while you no longer need a pap test every year, there are other cancers and conditions your doctor is looking for at your visit. (See Should I Come Back Next Year?) Do continue to see your doctor every year to make sure you keep your health on track.