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Ask the Medical Expert Archives 2000-2004

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Pap Smears
August 2002

Q. I am 65 years old. I just changed to a new doctor, an internist who has not been out of medical school very long. He asked me if my pap smears have been good all these years. I told him "Yes, never a problem." So he said I do not need a pap smear, and MAYBE he would do one every 3-5 years. I am on hormones, and Fosamax (I have osteopenia). Is this the new thinking on pap smears?

A. The Pap smear is a well-regarded test used to detect cancer of the cervix, the lower part of the uterus. It is recommended to be done yearly in young adult women, starting around age 21 or earlier if sexually active. Newer data suggests that the risk of cervical cancer is extremely low after menopause if Pap smears have been normal. Some experts say that if three Paps have been normal after menopause, no further Paps are needed. Women should still have regular physical exams for appropriate tests based on age, medical history, and family history. This will still include a pelvic exam. The controversy of taking hormones after menopause is an ongoing medical debate, which may influence your individual care as well. I encourage you to discuss these matters further with your doctor.



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