Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Cervical cancer guidelines leaves women confused about annual pelvic exams

Lisa N. Abaid, MD, MPH
Conditions
February 11, 2020
Share
Tweet
Share

There is good news and bad news in the world of women’s health.

The good news is that women do not need annual Pap smears. The bad news is that, upon hearing the good news, many women incorrectly assume they no longer need annual pelvic exams, either.

Historically, Pap smears were performed annually, and during the same time as pelvic exams, so it is understandable why women would conflate the two. But these exams are different, and it is important that women continue to undergo annual pelvic exams every year, starting at the age of 21.

Pap smears involve gently scraping cells from the cervix. The cells are then observed under a microscope for abnormalities that might indicate precancer or cancer. Many Pap tests now include testing for human papillomavirus, or HPV, the virus that causes cervical cancer. Pelvic exams, meanwhile, are an internal and external examination of the pelvic organs. During these exams, a woman’s doctor will check for signs of ovarian cysts, sexually transmitted infections, uterine fibroids, vulvar or vaginal conditions, as well as palpating the bladder and sometimes the rectum.

Pap screening has dramatically reduced the rates of cervical cancer in the U.S. and other developed countries. However, we have recognized that we can maintain the same level of protection with far fewer Pap tests. In fact, just five Pap tests during a woman’s lifetime can reduce the risk of cervical cancer by almost 75 percent.

That is why in 2018, the American College of Obstetrics and Gynecology (ACOG) issued new guidelines, suggesting that women ages 21 to 29 should have a Pap test every three years, while women ages 30 to 65 are advised to undergo a Pap test and HPV test every five years. Adhering to these guidelines reduces the risk of cervical cancer by almost 95 percent.

When I tell women this, they are understandably happy – few people want to undergo an uncomfortable procedure if they don’t have to. But many women are also concerned. The most common question I hear is, “If I’m only being tested every five years, how do you know I’m not going to get cancer in that time?”

There are two answers to this. The first is that we have very good data to show that even if you contract HPV the day after your Pap test, it would take (on average) five or more years for a significant lesion to develop.  The second goes back to that pelvic exam. Every year, when your doctor sees you, she’ll examine you with her eyes and her hands. If something looks or feels concerning, she can order a Pap or take a biopsy.

There is a third answer to the cervical cancer question that doesn’t have anything to do with Pap smears or pelvic exams. Since the HPV vaccine was introduced in 2006, cervical cancer rates and precancerous lesions have been declining. We can vaccinate against cancer, a fact that is truly amazing. As more people are vaccinated, we hope to see the rate of HPV-related cancers decline even further.

This month is cervical cancer awareness month, and I hope that in addition to being aware of the disease, women are aware of what they can do to prevent it: Vaccinate against HPV, undergo a Pap smear every three to five years, and see your doctor for a pelvic exam – every year.

Lisa N. Abaid is a gynecologic oncologist and co-director, Hoag Breast & Ovarian Cancer Prevention Program, Hoag Memorial Hospital Presbyterian, Newport Beach, CA.

Image credit: Shutterstock.com

Prev

Why doctors need life skills

February 11, 2020 Kevin 0
…
Next

The medicine that defines hospice care

February 11, 2020 Kevin 1
…

ADVERTISEMENT

Tagged as: OB/GYN

Post navigation

< Previous Post
Why doctors need life skills
Next Post >
The medicine that defines hospice care

ADVERTISEMENT

More by Lisa N. Abaid, MD, MPH

  • We have a shot at preventing cervical cancer

    Lisa N. Abaid, MD, MPH

Related Posts

  • We have a shot at preventing cervical cancer

    Lisa N. Abaid, MD, MPH
  • Hormone replacement therapy is still linked to cancer

    Martha Rosenberg
  • Obstruction of medical justice: How health care fails patients with cancer

    Miriam A. Knoll, MD
  • Despite progress in cancer care, cost and equity challenges still must be addressed

    David M. Aboulafia, MD
  • Using the Avengers to explain how cancer treatments work

    Jennifer Lycette, MD
  • Is social media a friend or foe of science?

    Michael Joyce, MD

More in Conditions

  • How veteran health care is being transformed by tech and teamwork

    Deborah Lafer Scher
  • What Elon Musk and Diddy reveal about the price of power

    Osmund Agbo, MD
  • Understanding depression beyond biology: the power of therapy and meaning

    Maire Daugharty, MD
  • Why medicine must stop worshipping burnout and start valuing humanity

    Sarah White, APRN
  • Why perinatal mental health is the top cause of maternal death in the U.S.

    Sheila Noon
  • A world without vaccines: What history teaches us about public health

    Drew Remignanti, MD, MPH
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • 5 blind spots that stall physician wealth

      Johnny Medina, MSc | Finance
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why flashy AI tools won’t fix health care without real infrastructure

      David Carmouche, MD | Tech
  • Recent Posts

    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician
    • How veteran health care is being transformed by tech and teamwork

      Deborah Lafer Scher | Conditions
    • Why judgment is hurting doctors—and how mindfulness can heal

      Jessie Mahoney, MD | Physician
    • Why medical schools must ditch lectures and embrace active learning

      Arlen Meyers, MD, MBA | Education
    • Why helping people means more than getting an MD

      Vaishali Jha | Education
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • 5 blind spots that stall physician wealth

      Johnny Medina, MSc | Finance
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why flashy AI tools won’t fix health care without real infrastructure

      David Carmouche, MD | Tech
  • Recent Posts

    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician
    • How veteran health care is being transformed by tech and teamwork

      Deborah Lafer Scher | Conditions
    • Why judgment is hurting doctors—and how mindfulness can heal

      Jessie Mahoney, MD | Physician
    • Why medical schools must ditch lectures and embrace active learning

      Arlen Meyers, MD, MBA | Education
    • Why helping people means more than getting an MD

      Vaishali Jha | Education
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Cervical cancer guidelines leaves women confused about annual pelvic exams
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...