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Menopause on Trial: Pap Smears & Pelvic Exams

feet in stirrups at a pelvic exam before a pap smear

The history of recommendations for Pap smears and pelvic examinations involves a lot of advisory groups and reflects both facts and factoids. The prevention of problems associated with human papilloma virus (HPV) and the early recognition of cervical, uterine, and ovarian cancers gets lumped into one series of recommendations.

We reviewed the most recent guidelines for Pap smears, physical exams, and HPV testing, published by the Centers for Disease Control, as well as the evidence that is backing them up, which is based on recommendations from four groups: U.S. Preventive Services Task Force (2018); American Cancer Society (2012); American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology (2012); American College of Obstetricians and Gynecologists (2016); and Society of Gynecologic Oncology (SGO) and American Society for Colposcopy and Cervical Pathology (2015).

Our jury has reached a verdict on the guidance and unpacked the recommendations in the following table. Where the research is conclusive, we labeled it a unanimous decision; where the organizations differ in their advice, we called it a hung jury; and where the organizations are vague and there is just not enough evidence, we have said so.

Pap Smear Recommendations

Pap Smear Graphic

Physical Exam Recommendations

Physical Examination Graphic

HPV Testing Recommendations

HPV Testing Graphic

About the author
Dr. Deb has more than 20 years of experience in academic medicine leadership positions, delivering educational programs on women's health and primary care research for healthcare workers in the United States, Europe, Asia, and Australia.

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