Pap Smears, Breast Screening, STIs, and More – Female Screening Guide
A screening test is defined as: “The examination of a group of usually asymptomatic individuals to detect those with a high probability of having or developing a given disease”. In other words, screening tests are done to assess risk, NOT for already symptomatic individuals.
A good screening test has the following attributes:
- Investigates an important health problem
- Effective and acceptable treatment is available
- The screening test itself is accurate and acceptable to patients
- Natural history of the condition should be adequately understood
- Overall benefits of screening outweigh harm
- Ensures informed choice, confidentiality and respect for autonomy for the patient
Pap smears [1]
WHAT: Measures the presence of abnormal cervix cells (called cervical dysplasia)
WHEN: Negative pap smear result = routine every 3 years
- 6 month follow up until 3 consecutive negative results, then return to routinely every 3 years
- may be referred for a colposcopy/cervical biopsy if results continue to be positive for abnormal cervical cells
Screening may be discontinued at age 70 IF three or more negative pap smears have been done in the previous 10 years
Breast exams [2]
WHAT: Self or clinical examination of breast tissue for irregular lumps, pain, nipple discharge, and skin discolouration to screen for breast cancer
WHO: Females with breast tissue, regardless of menstruation status
WHEN: Routine self breast exam or clinical breast exams are NOT recommended for screening – should only be done when clinically relevant (speak to your doctor)
Mammogram [2]
WHAT: X-ray that screens for potentially cancerous breast lesions
WHO:Age 50+
WHEN: Every 2-3 years
Chlamydia/Gonorrhea (STI) testing [3]
WHAT: Screens for presence of two commonly sexually transmitted bacteria
WHO: Sexually active females 24 years and younger
WHEN: Patients whose sexual history reveals new or persistent risk factors since the last negative test result.
Human Immunodeficiency Virus (HIV) testing [4]
WHAT: Testing for presence of the virus that is a risk factor for developing Acquired Immune Deficiency Syndrome (AIDS)
WHO: Age 15-65 year old; Sexually active; Pregnant females
- Men who have sex with men (and subsequently, the females who are sexually active with those men)
- Active injection drug users
- Positive for other sexually transmitted infections (STIs)
Increased risk populations:
- Unprotected vaginal or anal intercourse
- Sexual partners who fall under the high risk population category
WHEN: High risk populations = once a year
Increased risk populations = every 3-5 years
Routine re-screening not necessary in individuals who have not been at increased risk since testing HIV-negative
Females screened during a previous pregnancy should be re-screened in subsequent pregnancies
Many naturopathic doctors (including myself) offer gynecological exams (including pap smears) and breast exams in office. NDs have the luxury of time to make sure the patient is comfortable and understands the examination, as well as any test results that are done. This is a good option for those who don’t enjoy the 5 minute “in and out” experience many females have with their family doctor. Regardless of which healthcare practitioner you choose to go to, the most important thing is that you do the proper screening exams at the proper times. Speak to your doctor about screening today.
See my article about screening tests in males here.
