A decade ago, guidelines for cervical cancer screenings, or Pap tests, changed from being recommended annually to longer intervals based on age, past test results and medical history.
It’s a good thing to reduce the number of medical tests you have over a lifetime, says Dr. Calvin Channell, a medical director for BlueCross BlueShield of Tennessee. And the longer interval Pap test guidelines are proving to be effective in finding precancers, or cell changes of the cervix.
But health care providers are seeing that many women are now only scheduling a full well woman exam when their cervical cancer screenings are due even though a check-up every year is still recommended.
“There is confusion that a full gynecological exam every 3-5 years is all you need,” Dr. Channell explains. “Sometimes women also equate a Pap test as being the same as the examination.”
“If you have one of those assumptions, you’re missing other care and other screenings that could also bring better health or even be lifesaving.”
What you need to know about cervical cancer
More than 13,000 new cases of cervical cancer are diagnosed in U.S. women annually with about 4,200 deaths each year from the disease. That’s much lower than in past decades due to more widespread screening, education on screenings and improved access to care.
Pap tests can detect precancerous changes in the cervix called dysplasia. Close to one million women a year will learn they have dysplasia.
“That large a number who are diagnosed as precancerous demonstrates the importance of the screenings,” he says.
Recommendations on screenings and check-ups
Here are the cervical cancer screening guidelines from the CDC
- 21 to 29 Years Old
- Start getting Pap tests at age 21.
- If your test result is normal, your doctor may suggest you can wait three years until your next Pap test.
- 30 to 65 Years Old
- Talk to your doctor about these options: An HPV test only (human papilloma virus).If your result is normal, your doctor may tell you that you can wait five years until your next screening test.
- An HPV test + Pap test. This is called co-testing. If both of your results are normal, your doctor may tell you that you can wait five years until your next screening test.
- A Pap test only. With a normal result, your doctor may tell you that you can wait three years until your next Pap test.
- Over age 65, your doctor may tell you that you don’t need to be screened anymore if:
- You have had normal screening test results for several years, and
- You have not had a cervical precancer in the past, or
- You have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids.
Your doctor may suggest a different schedule for screenings if you have or have had:
- Previous cervical cancer diagnosis
- HIV or another condition which weakens your immune system
- Risk factors for urinary or other gynecological cancers
- Exposure to Diethylstilbestrol (DES) in utero (prior to being born)
These guidelines don’t change the recommendation for having an annual gynecological or well care exam.
“A Pap test is only one part of a pelvic exam. And a full pelvic exam is only part of the total care and screenings during an annual exam,” says Dr. Channell.
“If you’re not going each year, you’re not getting breast exams, screenings for STIs, blood pressure checks, bladder exams and opportunities for vaccines like the one to protect against HPV (human papilloma virus), the leading cause of cervical cancer.”
An obstetrician/gynecologist will also usually check to see if you’re getting care from another primary care provider. If not, your ob/gyn can order tests for cholesterol, anemia, thyroid levels, and more.
“Give yourself the best possible scenario for health and wellbeing by getting both exams when they’re recommended, Dr. Channell says.
Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.