The Heart has Bandaged Moments: Notes on Small Town Medicine
As a 30-something female, I've had many Paps. As a female doctor, I've performed many as well. My greatest concern, however, is the lack of information female patients are provided on the importance of cervical cancer screening, but also on the updated guidelines regarding the timeline for screening. For example, most women don't require a yearly Pap and women under 25 don't need them at all. When I tell patients this, they seemed surprised: "But my doctor says I need one every year" or "I was told I need one because I've become sexually active, even though I'm just 16." I thought I'd outline the guidelines for the general female patient here and hope they help alleviate some confusion.
When do I start cervical cancer screening?
The Canadian Task Force on Preventive Health Care recommends starting routine Pap tests at the age of 25. Routine Pap tests are NOT recommended for sexually active women under the age of 25. Routine Pap tests are also NOT recommended in women over the age of 25 who are not sexually active.
The Alberta TOP guidelines (Toward Optimized Practice) build on the Task Force suggestions, but highlight that for ages 21-24, screening can be based on patient choice and/or where women may benefit based on risk (i.e.: mulitiple sexual partners, no HPV vaccination, early teen sexual encounter, smoking).
Females under 21 should NOT be screened.