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Why have guidelines for getting Pap smears changed?

Patricia Geraghty, NP
Women's Health

Pap test guidelines have changed repeatedly and dramatically over the last 10-15 years. This is because of the explosion of knowledge in the cause of abnormal pap tests, human papilloma virus.

There are over a 100 strains of human papilloma virus (HPV). Some of these strains cause changes to cells in the cervix that can lead to cancer. Strains 16 and 18 are responsible for 70% of cervical cancers.

When HPV was first discovered in the 1980's, it was thought that it was a lifelong infection. We now know very differently. Not only do most people get HPV when they are sexually active, but most people also cure themselves. Estimates say that 80% of people will have HPV at some time in their lives, usually very soon after becoming sexually active. The virus then disappears within a few years in more than 90% of people. It's sort of like the common cold, both common and rarely serious.

It is the very few women who not only fail to cure HPV, but the HPV then goes on to cause abnormal paps, that need special attention. There's further good news however. HPV is slow to act. There are usually 7 to 10 years before HPV affected cells turn into cancer cells.

Frequent Pap testing will uncover new HPV infections and minor effects on cervical cells that are most likely to resolve without any attention. It is almost always less stressful and even potentially less harmful to the woman to let her own immune system clear the virus and repair any cell damage. That is why Pap tests remain very important but guidelines encourage less frequent testing so that we uncover and treat only those infections likely to cause serious harm.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.