- 7 years ago
- Wedding: September 2012
@pharmy: I hate to disagree with you, but Paps are not “required” until you become sexually active. It does have *everything* to do with HPV, because HPV, which is sexually transmitted (which includes intimate touching ie. fingers in/near vagina, not just penis in vagina) is the cause of 99.7% of cervical cancers, with 2 strains being responsible for 70% of cancers (hence the vaccination) and a handful of strains being responsible for 95+% of strains. Most clinical guidelines say age 21 or once sexually active….but really the age 21 parameter comes from the fact that many women won’t disclose sexual activity to their care providers.
Now, there are other tests done during a speculum exam, namely vaginal and cervical swabs for other issues like Chlamydia, Gonorrhea, yeast, bacterial vaginosis, etc. So one could argue that there’s more to a speculum exam than an Pap test and cervical cancer screening.
Lastly, vaginal infections can indeed cause inflammatory changes in cervical cells that are detected on Paps. These, however, are not cervical cancer nor cervical dysplasia. Infections other than HPV can cause unusual Pap findings but they don’t cause dysplasia (pre-cancer) or cervical cancer.
If a woman is honest with her care provider about when she started sexual activity, there’s no clinical evidence that Paps should be done before that time. One may even argue that if a woman trusts her partner that they were both virgins and are now monogamous that she could forego Paps completely….although I’m not sure I’m that trusting but I’m cynical that way.
ETA: keep in mind that correlation does not equal causation, eg. risk factors for cervical cancer include BCP use, HSV infection, smoking, low socio-economic status, young age of first intercourse, etc…..these things do not cause cervical cancer but the people that have these characteristics tend to also have higher cervical cancer rates
ETA2: here’s the most recent guidelines from ACOG for the American bees:
Testing starts age 21 and then every 3 years. Annual cervical screening is not recommended.