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Age limit on Pap Smears
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Kimgangi posted:
I took my 16 year old daughter how is sexually active to get on the pill and I was told that they don't do pap smears until she is 21. Is this correct? I have never heard this before and I thought since she is sexually active, she should have a pap smear.
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georgiagail responded:
Do you have a local Planned Parenthood Organization where you live? If so, contact them.

Gail
 
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rowines responded:
had my first pap smear when i was 15 years old my other friend when she was 14. I went to my local health department to get mine done. Whether she is sexually active or not there is no reason to be turned down.
 
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Namiai responded:
This is not true i graduated high school last year. When i was 17 i got one and yes they do recommend it i would take your health care else were sounds like they dont care. They recommend it for children as young as 4 if they have been sexually assaulted. Also its recommended for 13 and up if you believe your child may be having sex.
 
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Jane Harrison Hohner, RN, RNP responded:
Dear Kimgangi: There has been a recent change in the recommendations governing PAP smears in young women. Newer studies have suggested that HPV infections (linked to abnormal PAP smears) tend to resolve in younger women. This may be due to better immune system function which fights off the HPV more effectively.

A newer recommendation was to wait until three years after starting intercourse --based upon the hope that many HPV infections will be spontaneously cleared. Also, abnormal cervical cells do not progress quickly to cervical cancer.

One well done study by Ho and colleagues (1998) followed older adolescents over three years. At the end of the study some 43% became HPV positive. This confirms the ease with which HPV can be passed between sexual partners. Surprisingly, of this group of newly infected women, only 9% continued to show persisting evidence of HPV.

The very newest (2009) recommendations for cervical cancer screening are now:
"022 Women over the age of 30 can now get PAP smears only every three years IF they have had three normal PAP smears in a row.
"022 If women have risk factors (e.g., as prior abnormal PAPs), or have decreased immune functions (e.g., organ transplant recipients, HIV) they should get more frequent PAP smears.
"022 Routine screening PAP smears should begin at age 21—not as a teenager.
"022 Women who have received the HPV vaccine to reduce cervical cancer are still subject to these standards. But as more data is gained this may be reassessed.

For women who have been assaulted or sexually molested while very young, it is important that they get a PAP smear earlier. If the assault was in childhood, she should get a PAP as a teenager for there are several factors which place her at increased risk for abnormal PAP smears.

Yours,
Jane
 
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An_239650 replied to Namiai's response:
What??? WHO is "they" that recommends a pap smear for a 4 year old?That would also be assault. As it usually takes about 10 years for HPV infection to turn to cervical cancer in those rare cases it is proposterous to recommend that!!!! How cruel for the poor child.
It is also NOT recommended for 13 and up if they are having sex either. CHECK YOUR FACTS!!!!!
 
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samricks responded:
I began getting a pap at the age of 12, shortly after i had my first period. I have gotten one every year since then and i have abnormal cells, so i am supposed to go 2 times a year. Well i went to my health department for the 2nd time earlier this year and they told me they would not do one on me cause they changed the age to 21. i told them i needed it and they still said no. so now, i guess i learned that it is 21 for sure...
 
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mgscrnp24 replied to Namiai's response:
I don't know where you obtained this ridiculous information. No one advocates pap smears for 4 year olds just because they were sexually molested/assaulted. In fact, vaginal exams are done on these poor girls only in order to obtain specimens for STD testing and DNA samples, ASAP after the assault and they aren't even done with a regular speculujm--we always used a nasal speculum when I worked in the ED. That way we could at least look for trauma that could be documented for future legal purposes. I no longer work with sexual assault victims so I cannot state with authoritiy how the exams are completed now. Until the American College of Obstetricians and Gynecologists (ACOG) came out with these new recommendations, in late November, early December 2009, 13 year olds might have been getting Paps, IF they became sexually active at 10! I have had women in my clinic tell me that they became sexually active as young as 11. Thank goodness someone finally paid attention to studies and realized that we were overtreating mildly abnormal Paps such as ASCUS with positive HPV with invasive procedures like LEEP, cryo, etc. that could eventually cause difficulty getting pregnant or carrying a pregnancy to term because of a scarred or weakened cervix. Everyone, please remember that medicine is not an exact science. It is constantly changing. What was true 1 year ago, may no longer be "true". That is why we do research, read research, have specialists who review all the recent studies as a group, and develop new recommendations based on the newest research. Would you want to be treated with the chemotherapy drugs that were developed 20 years ago for treating breast cancer if there are newer and less caustic, but still as, or more, effective than the old ones? I think not. If you are allergic to penicillin and might die if you take it, would you refuse to take a newer antibiotic because it is not the "best" drug available as PCN might be? We have to think about what is "best practice" and evidence-based practice", the costs, the potential side effects, and lots of other stuff as we continue to advance research, new surgical procedures, new drugs, and new screening recommendations. (Think of the ruckus because of the change in recommendation that we don't start mammograms until age 50!) Will you continue to demand a Pap smear every year, even though it is not recommended, just because you have "always" done so? What if your insurance won't pay for it but every other year? Will you pay for it out of pocket? This is just one of the reasons our healthcare costs are so enormous. (I have to admit, some medical providers continue to tell their patients to have a Pap annually, even though their Paps have always been normal. I have to wonder if this a quick way to "make a buck"
 
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mgscrnp24 replied to samricks's response:
If you have had abnormal cells on every Pap smear since the age of 12, what kind of follow-up have you had? (colposcopy, LEEP, cryo, etc. If you have had ASCUS with HPV and it has not progressed, you still need to be having them, especially if the HPV is high risk. If your last 3 were still abnormal, take a copy to the Health Department and explain to them why you need to continue to have them. There are algorithms on the ASCCP web site for each level of abnormal Pap result. Take a copy to your health provide and make your case with that as evidence. http://www.asccp.org/Portals/9/docs/pdfs/Consensus%20Guidelines/algorithms_cyto_07.pdf
 
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someonewhocares3 responded:
It's also important to know:
· most abnormal pap smears are caused by inflammation and not disease
· the false positive rate of pap smears (indicates abnormal cells when none exist) is 45%
· abnormal cells in the cervix and uterus oftentimes revert to normal on their own; no treatment needed

All abnormal paps should be repeated a couple of times before any treatment is done. Removal of cervical tissue can cause infertility and inability to carry a baby to term (incompetent cervix). So you don't want to have unnecessary treatment.
 
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someonewhocares3 replied to someonewhocares3's response:
The bullet symbol in Word evidently converts to ? when pasting into WebMD!!

I'll repost this.
 
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someonewhocares3 responded:
It's also important to know:
- most abnormal pap smears are caused by inflammation and not disease
- the false positive rate of pap smears (indicates abnormal cells when none exist) is 45%
- abnormal cells in the cervix and uterus oftentimes revert to normal on their own; no treatment needed

All abnormal paps should be repeated a couple of times before any treatment is done (don't recall the interval of repeat paps). Removal of cervical tissue can cause infertility and inability to carry a baby to term (incompetent cervix). So you don't want to have unnecessary treatment.
 
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Anon_24218 replied to someonewhocares3's response:
Thank you for adding this information.


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