MOUNT VERNON — The new recommendations for mammograms is not the only health care issue to cause recent turmoil within the medical field.
The U.S. Preventative Task Force, a panel of doctors and scientists, years ago published new guidelines regarding Pap smears, raising the age of a routine Pap to 21. The task force also said women no longer needed to have a Pap every year; instead, every two years will be sufficient in catching slow-growing cervical cancer. For women 30 years and older, waiting three years between three consecutive clear Pap test should be recommended.
It was only recently, however, that these guidelines were adopted by the American College of Obstetricians and Gynecologists.
“Up until now we have always done them at 18, or when the patient first has had intercourse because that is when you can develop Human Papillomavirus,” said Dr. Alan Fairchild, Knox Gynecological Specialists.
The Center for Disease Control and Prevention defines HPV as a sexually transmitted infection that infects the skin and mucous membranes of the genital areas of men and women. The CDC stated on its Web site that HPV cannot be seen, and that most people who have it, don’t realize they do. Pap smears test for such abnormalities or pre-cancerous changes in the cervix. HPV has the potential of low risk, causing genital warts, or high risk, causing cancer. In most cases, the body’s immune system clears the HPV infection naturally within two years.
“But HPV virus, even if they have intercourse at 15, 16 and 17, takes a long time for it to change the cervix, so between 21 and 23 is when we absolutely start to do a Pap every year,” said Fairchild.
As precaution, Fairchild said, “If I have a young lady who is having intercourse regularly I will do a Pap smear before that period of time. I still try to do them at 18, especially if they are coming in for birth control and at that point they are going to have intercourse; since they have intercourse, they are a prospect. And it usually takes the HPV virus two to four years to develop a serious lesion; it’s a slow growing process.”
Fairchild said despite what the government is saying, women still want to have Pap smears every year.
“The government is not interested in good medical care, they are interested in cost saving. You’re not going to save a great number of people by doing it early, but you are going to get some individuals who have a cancer that you can cure early,” he said. “In my mind, every woman should still have a Pap Smear after age 21 until they get to be 70. If they had three normal Pap Smears before the age of 70, then they probably don’t need to get one any more.”
The Pap smear recommendations released by the government task force came out a long time ago, said Dr. Amy Murnen of Mount Vernon Family Practice, and she has been following those ever since.
“It was only recently that the American College of Obstetricians and Gynecologists adopted them, but my college of family physicians has followed those guidelines for years,” she said. “So if you always had normal Pap smears, then you need one every two to three years as long as you’ve never had any abnormal ones, and you have been normal three years in a row.”