How frequently should I do a pap smear or a mammogram?

So you've probably put off going to the doctor the last few months. Covid-19 was a great excuse, but let’s face it not many women enjoy the trip to the gynecologist. Something about the anxiety of finding something wrong makes women postpone the all-important exam.

What exams are really needed for a woman to keep herself healthy? The answer is age dependent. The younger you are the less your need for preventative care.

Preventive care basics

Do you know the difference between screening tests and diagnostic tests? A diagnostic test tells you “yes” you have a specific disease or “no” you do not have a specific disease. Most diagnostic tests are expensive. So most often your doctor starts with a “screening test,” which tells you you have a high likelihood of having a disease or not. If you have a high likelihood of having a particular disease then you move on to a diagnostic test.

Pap smear

The pap smear (smear test or pap) is a screening test for cervical cancer. As a screening test it does not tell you that you definitely have cervical cancer, but rather can tell you if you have a high likelihood of having cervical “pre-cancer.” The idea is to identify precancer early on and treat it before it becomes cancer.

I usually recommend that women follow whatever screening protocol is done in their home country. For American and Canadian women this is the American College of Obstetrics and gynecology recommendations of a pap smear every three years starting at age 21. After 30, a woman can have a pap and HPV test every five years. Many women are used to having a pap every year per old guidelines. This is a discussion to have with your doctor to take into consideration your risk of getting cervical cancer.

Mammograms

Mammograms are screening tests for beast cancer. A mammogram can pick up breast cancer three years before you actually feel a lump in your breast. A mammogram does not diagnose breast cancer but rather alerts your doctor about abnormalities in your breasts that then would require a biopsy to detect cancer.

Again, I recommend that women follow what is recommended in their home country. This is a bit more controversial than the pap smear as even within a country different organisations recommend different screening protocols. In the US the American College of Obstetricians and gynecologists recommend starting mammograms at age 40 and then doing them every one or two years.

Check the basics

Other screening tests are the basics of having your blood pressure taken when you go to the doctor, checking your BMI or Body Mass Index ( height and weight). Your doctor should also inquire about habits like smoking and exercising. Other screening that should be done for women is for domestic violence, depression, and sexual dysfunction. Again, the goal is to identify problems and take action before you become sick from common diseases like high blood pressure, obesity and depression.

With Covid-19 doctors should also ask questions about immunisations. All adults should be up to date on common immunizations for tetanus, diphtheria and pertussis (Tdap vaccine), measles, mumps and rubella (MMR vaccine) and the flu vaccine. If you were to get one of these infectious diseases this could lower your immunity and put you at risk of getting Covid-19.

Jennifer Kasirsky, is an obstetrician and a gynecologist with more than 20 years of experience. She is currently head of department, Obstetrics and Gynecology Mediclinic Parkview Hospital