Cervical Health Q&A with Physician Stefani Russo

Russo Stefani

Stefani A. Russo, MD

Dr. Stefani Russo is a physician in Jefferson Women’s Primary Care, and is interested in all aspects of women’s health, management of chronic disease, educating medical trainees, and working to improve how we provide primary care.

Question:

I am a 29 year old woman. I am embarrassed to ask this, but why do women need Pap smears?

Answer:

This is a great question and one that many women don’t know the answer to. The short answer is that we do Pap smears to prevent cervical cancer. When you have your Pap smear, your doctor is collecting a small sample of cells from your cervix (your cervix is located at the end of your vagina and is the “door” to the uterus). These cells are then looked at closely under the microscope. If the cells don’t look normal, your doctor will recommend next steps to closely monitor or remove those cells before they have the chance to change into cervical cancer.

Question:

My daughter is 20 years old. She has never had a pap smear. Her doctor said she doesn’t need one yet. Is that right?

Answer:

Your daughter should get her first pap smear at age 21. The starting age for Pap smears was changed to 21 years old based on very good data that says that doing pap smears earlier than that doesn’t have any benefit. If her first Pap smear at age 21 is normal, she would get her next Pap smear 3 years later.
Question:

I am a 45 year old healthy woman. How often should I be getting Pap smears?

Answer:

If your Pap smear is normal, you should have a repeat Pap smear every 3 years.

If your doctor does a Pap smear and HPV testing together, and both are normal, then you can wait 5 years before your next repeat test.

Question:

The last time I went to my doctor, she also tested me for HPV. What is HPV?

Answer:

HPV, or Human Papilloma Virus, is a sexually transmitted virus that causes cervical cancer. There are certain types of HPV that cause cervical cancer; other types of HPV cause skin warts or genital warts. Many women who have HPV infection will get rid of the infection on their own, and never develop cervical cancer.  Some HPV infections, however, can linger for many years and over time, and cause changes in the cells of the cervix that can develop into cancer. Doing regular pap smears and testing for HPV helps to find these changes before they can develop into cancer.

Question:                 

I am a 57 year old woman who had a hysterectomy because of fibroids. My doctor also removed my cervix during my surgery. Do I still need Pap smears?

Answer:

Women who have had total hysterectomy (meaning their uterus AND cervix were removed) due to fibroids do not need to have additional Pap smears if their previous Pap smears were normal.  Women who have had a hysterectomy, but still have their cervix, should have regular cervical cancer screening with Pap smears and HPV testing.  If you are unsure whether you have your cervix after your hysterectomy, your doctor can do a pelvic exam to look for your cervix.

Question:

When can I stop getting Pap smears? I’m 70 years old and have always had normal Pap smears.

Answer:

Most groups recommend that a woman can stop getting cervical cancer screening at age 65 if:

  • She has had normal cervical cancer screening before-hand ( 3 Pap smears or 2 Pap smears/HPV testing in the past 10 years)
  • Has not had a history of CIN (cervical intra-epithelial neoplasia) 2 or 3 CCervical or cervical cancer

 

The guidelines can be confusing, so ask your healthcare provider about this information during your next visit.

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