Quick, what about annual pap smears?
In 2012 the world of women’s health was shaken by the publication of opinions stating women should go as long as 5 years between pap smears. While this never meant going more than a year between exams for the sake of prevention and early detection of many problems women may develop, the idea that pap smears could be deferred so long was really shocking. What about how we had been telling women for approaching 100 years that annual pap smears prevented cervical cancer… women could find a pre-cancer when it was at a completely curable stage and resolve the problem… what about that?
The new recommendations were based on opinions put forth in a study that, I think, if women were aware of their pre-suppositions, they would clearly not agree.
What pap smears always did was prevent cervical cancer as I stated above, by catching pre-cancers early and curing them. And even when cancers were found, they were most often found at an early and curable stage.
This 2012 study changed the whole focus of attention. Where in the past our goal in women’s health care was to prevent cancer, and prevent the deaths and debilitation that go with treating cancer, this study proposed that really what you want to avoid is the procedure that diagnoses cancer once a pap smear has indicated the need of it. Colposcopy is the procedure where a microscope is stood in front of a patient while a pelvic exam was done to look closely at the cervix and do biopsies of suspicious areas when a pap smear had raised suspicion. The pap screened and the colposcopy with biopsy diagnosed. This 2012 study suddenly proposed that rather than working to avoid cancer in women, what we should be doing is avoiding colposcopy. They set up their study to demonstrate that when you do fewer pap smears, you end up with fewer colposcopies, and therefore women were better off…. DUH!
The sad result of this study is that many physicians took that ball and ran with it. Now, 5 years after this study was published, here are the tragic estimates: 195,000 cases of invasive cancers that would have been prevented with annual pap smears, and 44,000 preventable deaths.
Is this OK with you? While Medicare is the only insurance that I am aware of that with this recommendation took the position that they would not pay for annual pap smears, when I talk to women and explain this to them, they uniformly tell me that even if their insurance did one day refuse to pay for the pap smear, they are willing to pay that $50 themselves.
Cervical cancer is no one’s preferred way to die. If you have further questions about this issue, please come in and let’s discuss it.
If this is enough to convince you, call and let’s get your annual well-woman exam and pap smear done. Waiting is just not worth it!