topic Re: New guidelines for pap tests? in Community Chat

New guidelines for pap tests?

Mominohio — Thu, 18 Sep 2014 13:30:10 GMT

I thought this might get more viewings (and answers) here than in the health section, as I don't know how active that is over there.

I went for my yearly pap and mammogram yesterday and was surprised to be told that the new guidelines for pap tests (and she told me what medical organization said so, but I can't remember) is now only once every three years.

I asked why, (I think it always boils down to money) and she said that they have determined that cervical cancer is such a slow growing cancer that every three years is sufficient.

It wasn't until I left that I thought about all this HPV hype the last few years. Bad enough that they are pushing the vaccine on both girls and now boys. If HPV is a possible cause of cervical cancer (do I have that right?) why would it be so important to get the vaccines, yet curb the testing. Makes no sense to me.

Anyone here in the healthcare field and can weigh in on this one? Thanks in advance.

Re: New guidelines for pap tests?

Financialgrl — Thu, 18 Sep 2014 13:41:39 GMT

I'd been told the same thing but not by my GYN, by my oncological surgeon. The guidelines though included age (50+) and one in a stable relationship. Kind of rules out the young and those that are on the pill which still require a yearly exam when on it.

Oops, ETA: no exam required with the above guidelines AND if your last 3 yearly pap smears had no issue.

Re: New guidelines for pap tests?

FrostyBabe — Thu, 18 Sep 2014 13:45:49 GMT

On 9/18/2014 BeanCounter17 said:
I'd been told the same thing but not by my GYN, by my oncological surgeon. The guidelines though included age (50+) and one in a stable relationship. Kind of rules out the young and those that are on the pill which still require a yearly exam when on it.

Oops, ETA: no exam required with the above guidelines AND if your last 3 yearly pap smears had no issue.

That's the same thing that my PCP told me last year when I went in for my annual festivities.

Re: New guidelines for pap tests?

biancardi — Thu, 18 Sep 2014 13:46:15 GMT

it is based on age. I get them yearly and they are covered

it is just a ""guideline"" - your 0b/gyn doesn't have to follow it and you can ask for it.

why is the HPV vaccination a ""bad thing""? I think it is a life saver and is no different than other vaccinations that saved lives and prevented disease.

Re: New guidelines for pap tests?

Lila Belle — Thu, 18 Sep 2014 13:48:08 GMT

On 9/18/2014 biancardi said:
it is based on age. I get them yearly and they are covered

it is just a ""guideline"" - your 0b/gyn doesn't have to follow it and you can ask for it.

why is the HPV vaccination a ""bad thing""? I think it is a life saver and is no different than other vaccinations that saved lives and prevented disease.

I don't get that either.

Re: New guidelines for pap tests?

gazelle77 — Thu, 18 Sep 2014 13:50:04 GMT

I learned about this about 5 years ago. Not new news really.

Re: New guidelines for pap tests?

Mominohio — Thu, 18 Sep 2014 13:55:03 GMT

On 9/18/2014 Lila Belle said:
On 9/18/2014 biancardi said:
it is based on age. I get them yearly and they are covered

it is just a "guideline" - your 0b/gyn doesn't have to follow it and you can ask for it.

why is the HPV vaccination a "bad thing"? I think it is a life saver and is no different than other vaccinations that saved lives and prevented disease.

I don't get that either.

I don't know for sure that the vaccine is a bad thing, I just question all the vaccines that are out now, and feel that perhaps in the long run, there may be side effects that won't be seen until years (or decades) down the road. I don't think that we always get a real picture early on of the possible side effects of drugs and vaccines because they come to market relatively quickly, and we often see problems with them down the road. I'm not one to run out and get every new shot or vaccine that comes down the pike. I think it requires more thought and research (and time to see results) than some people give it. It is just my personal preference to not always choose drugs first.

I guess my point was that we push the vaccines, that don't have nearly the track record the pap test does, and pull back on the tests that we have used for decades and, to my knowledge, have no real problems.

Re: New guidelines for pap tests?

Mominohio — Thu, 18 Sep 2014 13:57:34 GMT

On 9/18/2014 biancardi said:
it is based on age. I get them yearly and they are covered

it is just a "guideline" - your 0b/gyn doesn't have to follow it and you can ask for it.

why is the HPV vaccination a "bad thing"? I think it is a life saver and is no different than other vaccinations that saved lives and prevented disease.

What I fear is that what is now just a "guideline" will soon be practice, because if insurance companies and the government can get out of paying for these tests, they will, and if they aren't covered by insurance (eventually, maybe some are already limiting them to the new guidelines) many women won't get them.

Re: New guidelines for pap tests?

Sushismom — Thu, 18 Sep 2014 13:58:55 GMT

These guidelines have been out for several years now. Pap tests not only detect cervical cancer but also any dysplasia. It can take 10-20 years for cervical cancers to develop from precancerous changes. There's really no reason (unless you've had a positive Pap test) to have one yearly if you're in a low risk group.

As for the HPV vaccine, why not? The high-risk HPV types don't only cause cervical cancer; they are also responsible for other types of cancer such as vulvar, penile, and oral.

Re: New guidelines for pap tests?

Qwackertoo — Thu, 18 Sep 2014 14:04:38 GMT

Mine is due next month. Yearly . . . so far. AND they do an ultrasound of my ovaries due to family history . . . Mother died from ovarian cancer. So I don't expect it to change for me.

I had an appt. for the mammo on Monday . . . and they called late Friday and the machine(s) will be down for maintenance . . . so had to re-schedule. I'll never forget the year I had fractured my ankle and was in a cast and crutches and had to get it standing on one leg . . .and with the aluminum crutch, only one, had to switch side I was holding it with for balance . . . I told the technician or operator (whatever they are called?) that I was her "challenge" patient for the day.

Re: New guidelines for pap tests?

terrier3 — Thu, 18 Sep 2014 14:05:50 GMT

On 9/18/2014 mominohio said:
On 9/18/2014 biancardi said:
it is based on age. I get them yearly and they are covered

it is just a "guideline" - your 0b/gyn doesn't have to follow it and you can ask for it.

why is the HPV vaccination a "bad thing"? I think it is a life saver and is no different than other vaccinations that saved lives and prevented disease.

What I fear is that what is now just a "guideline" will soon be practice, because if insurance companies and the government can get out of paying for these tests, they will, and if they aren't covered by insurance (eventually, maybe some are already limiting them to the new guidelines) many women won't get them.

I don't think this applies to ALL women - just women who have had clear Pap tests for years, who are in a monogamous relationship and have no cervical cancer in their family.

I look at it from the other angle - we have far too many tests that are unnecessary in the USA. I'm sure these guidelines were studied for YEARS - and I think they are more in line with other countries too. Why go through procedures that are expensive if they are not helpful or required? It's the same thing with prostate cancer tests too. It's slow growing in senior men and testing every year isn't required.

BTW - I'm sure that finances played a very reduced role in this decision. It's more cost effective for insurance companies and Medicare to catch cancer in it's earliest stages - not wait until someone needs extensive surgery, chemo, etc.- that's what costs them a TON of money! If they feel that 3 years between tests will not lead to more extensive cancer treatments later on...it works for me!

Re: New guidelines for pap tests?

Mominohio — Thu, 18 Sep 2014 14:13:31 GMT

On 9/18/2014 terrier3 said:
On 9/18/2014 mominohio said:
On 9/18/2014 biancardi said:
it is based on age. I get them yearly and they are covered

it is just a "guideline" - your 0b/gyn doesn't have to follow it and you can ask for it.

why is the HPV vaccination a "bad thing"? I think it is a life saver and is no different than other vaccinations that saved lives and prevented disease.

What I fear is that what is now just a "guideline" will soon be practice, because if insurance companies and the government can get out of paying for these tests, they will, and if they aren't covered by insurance (eventually, maybe some are already limiting them to the new guidelines) many women won't get them.

I don't think this applies to ALL women - just women who have had clear Pap tests for years, who are in a monogamous relationship and have no cervical cancer in their family.

I look at it from the other angle - we have far too many tests that are unnecessary in the USA. I'm sure these guidelines were studied for YEARS - and I think they are more in line with other countries too. Why go through procedures that are expensive if they are not helpful or required? It's the same thing with prostate cancer tests too. It's slow growing in senior men and testing every year isn't required.

BTW - I'm sure that finances played a very reduced role in this decision. It's more cost effective for insurance companies and Medicare to catch cancer in it's earliest stages - not wait until someone needs extensive surgery, chemo, etc.- that's what costs them a TON of money! If they feel that 3 years between tests will not lead to more extensive cancer treatments later on...it works for me!

Terrier3, you are right, she did mention the part about having good pap history, and that part does make some sense, that it isn't a blanket guideline for all women.

I wish I could be as sure as you about the finances part. I think that more and more of our society (including the government and insurance companies in this case) are looking for the easy now (saving billions? by reducing testing) and turning a blind eye, or will worry about the long term costs down the road. I just don't have that much faith in "the system".

Re: New guidelines for pap tests?

Sushismom — Thu, 18 Sep 2014 14:20:12 GMT

Here are some of the steps that may be taken when a Pap test detects even precancerous changes.

1. HPV screening

2. Colposcopy and biopsy

3. Cone biopsy

These are all way more expensive than a Pap test.

Re: New guidelines for pap tests?

brii — Thu, 18 Sep 2014 14:25:00 GMT

I'll continue to get a yearly Pap and mammo.

I have not had my girls vaccinated with Gardisil, and I don't think I will. They can get it up to age 26; if they feel they want to get it, they can do it themselves.

Re: New guidelines for pap tests?

terrier3 — Thu, 18 Sep 2014 14:28:04 GMT

On 9/18/2014 mominohio said:

Terrier3, you are right, she did mention the part about having good pap history, and that part does make some sense, that it isn't a blanket guideline for all women.

I wish I could be as sure as you about the finances part. I think that more and more of our society (including the government and insurance companies in this case) are looking for the easy now (saving billions? by reducing testing) and turning a blind eye, or will worry about the long term costs down the road. I just don't have that much faith in "the system".

There are now a LOT of new protections for consumers re: health care, thanks to the ACA.

There are no restrictions on pre-existing conditions - you can receive a new insurance policy even if you have a disease now, you can't reach an annual treatment "cap" or a lifetime "cap" - insurance must continue paying for your treatments. You can't be dumped from a plan if you become sick & need costly treatments.

All of those things could happen in the past.

Of course insuring that people continue receiving treatment for expensive diseases costs a lot of money - so saving money by not performing tests on people with reduced risk (like the 3 year Pap testing for healthy women with no family history) will help offset that.

Re: New guidelines for pap tests?

biancardi — Thu, 18 Sep 2014 14:41:01 GMT

you can always pay for it out of pocket if you really want the test.

Re: New guidelines for pap tests?

Qwackertoo — Thu, 18 Sep 2014 14:48:02 GMT

On 9/18/2014 biancardi said:
you can always pay for it out of pocket if you really want the test.

IF my BCBS were to stop covering, that is exactly what I would do. For me, personally, it would be a "small" price to pay for a little piece of mind . . . while not a guarantee . . . I'd gladly pay. One of those ounce of prevention better than a pound of cure . . . or however that old saying goes . . . I usually manage to mangle them up.

Re: New guidelines for pap tests?

Lila Belle — Thu, 18 Sep 2014 14:53:24 GMT

On 9/18/2014 terrier3 said:
On 9/18/2014 mominohio said:
Terrier3, you are right, she did mention the part about having good pap history, and that part does make some sense, that it isn't a blanket guideline for all women.

I wish I could be as sure as you about the finances part. I think that more and more of our society (including the government and insurance companies in this case) are looking for the easy now (saving billions? by reducing testing) and turning a blind eye, or will worry about the long term costs down the road. I just don't have that much faith in "the system".

There are now a LOT of new protections for consumers re: health care, thanks to the ACA.

There are no restrictions on pre-existing conditions - you can receive a new insurance policy even if you have a disease now, you can't reach an annual treatment "cap" or a lifetime "cap" - insurance must continue paying for your treatments. You can't be dumped from a plan if you become sick & need costly treatments.

All of those things could happen in the past.

Of course insuring that people continue receiving treatment for expensive diseases costs a lot of money - so saving money by not performing tests on people with reduced risk (like the 3 year Pap testing for healthy women with no family history) will help offset that.

Just adding that many tests doctors ordered in the past were unnecessary and expensive for the patient.

Re: New guidelines for pap tests?

Suziepeach — Thu, 18 Sep 2014 15:10:04 GMT

mominohio, I knew about the new guidelines a while back & thanks for this thread- my three years due is the end of October- got that bad boy scheduled.

Re: New guidelines for pap tests?

Mominohio — Thu, 18 Sep 2014 15:27:49 GMT

On 9/18/2014 Peachysue said:
mominohio, I knew about the new guidelines a while back & thanks for this thread- my three years due is the end of October- got that bad boy scheduled.

Seems like I'm late to the party on this one. Don't know if our office was just being conservative and waited longer to implement the new guidelines, or what, but I had never heard it before yesterday.

Regardless, we ladies can think of a million other things we'd rather do that get the yearly stuff done, even though it isn't terrible, so I hope my starting this at least gives a reminder where needed to get on the phone and get those appointments made. I think we all need a push now and then for this stuff.