would you Pap smear

[Denial]

screen a 24 year old virgin( sexually inative ) female with no risk factor.
plese post a link with the url so I can make others read it.

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[AJM]

Short answer: yes.
Here's the link to the guidelines on cervical cancer screening: http://www.ahrq.gov/clinic/uspstf/uspscerv.htm

The guidelines state that the primary care physician should begin "screening within 3 years of onset of sexual activity or age 21 (whichever comes first) and screening at least every 3 years".

 

[Denial]

Short answer: yes.
Here's the link to the guidelines on cervical cancer screening: http://www.ahrq.gov/clinic/uspstf/uspscerv.htm

The guidelines state that the primary care physician should begin "screening within 3 years of onset of sexual activity or age 21 (whichever comes first) and screening at least every 3 years".

Thanx I did not know this!
would you pap a 24 year old who had conerns of her taying a virgin before marriage?

 

[synapse]

Thanx I did not know this!
would you pap a 24 year old who had conerns of her taying a virgin before marriage?

you don't lose your virginity by having a pap smear...

also, you probably will not break her hymen by just placing the plastic thing inside

 

[AJM]

you don't lose your virginity by having a pap smear...

also, you probably will not break her hymen by just placing the plastic thing inside

Correct.

Although I find that when I do Pap smears on my patients who are virgins, the exam is much more comfortable for them when I use a pediatric speculum. (makes it a little more difficult to find the cervix, but less painful for the patient).

 

[Denial]

Correct.

Although I find that when I do Pap smears on my patients who are virgins, the exam is much more comfortable for them when I use a pediatric speculum. (makes it a little more difficult to find the cervix, but less painful for the patient).

ok htanx,
Now I know
I swear I didnt know this. I feel stupid as I am done with my step 3 and an intern. but i went to a foreign med school. Although that is no excuse as I took all the usmle step 1,2 and 3.

 

[dr_almondjoy_do]

pediatric speculums are also usefull for post-menopausal women with atrophic vaginitis, and especially women who have been sexually inactive for a long period of time, and nulliparous.

 

[seattledoc]

Short answer: yes.
Here's the link to the guidelines on cervical cancer screening: http://www.ahrq.gov/clinic/uspstf/uspscerv.htm

The guidelines state that the primary care physician should begin "screening within 3 years of onset of sexual activity or age 21 (whichever comes first) and screening at least every 3 years".

I just read the guideline that you wrote and came to a different conclusion than you... The guideline starts out by saying that pap smears are beneficial for sexually active women that have a cervix, and that screening should begin within 3 years of onset of sexual activity or at age 21 (if onset of sexual activity started at 19 or 20 years old. In other words, in a sexually active women with onset of sexual activity at age 20, don't wait until age 23 for the pap, get it earlier (at age 21).

If she is a virgin, what are you looking for with the pap smear? isn't cervical cancer sexually transmitted? Look at the risk factors for cervical cancer, this woman likely has none.

She should be offered the test but told that her risk is exceedingly low and that she should get one after she is sexually active.

peace

 

[seattledoc]

THe first line should read "I just read the guidelines that you quote" (sorry)

 

[edfig99]

6there are three major guidelines for cervical cancer screening -- the US Preventive Services Task Force which was quoted above, the American Cancer Society (ACS) and the Americal College of Obstetricians and Gynecologists (ACOG), but are almost all the same. ACOG recommends annual screening approximately 3 years after initiation of sexual intercourse, but no later than age 21. (it used to be age 18). ACOG's guideline is summarized here http://www.aafp.org/afp/20031215/clinical.html#1 and the ACS guideline is summarized somewhere on this page http://www.cancer.org/docroot/PED/c...ncer_Detection_Guidelines_36.asp?sitearea=PED

i too see little utility in screening someone who has not had vaginal intercourse with pap smears for cervical cancer (since it IS a sexually transmitted disease), however from what some of my colleagues have told me, part of the rationale for the recommendation of screening by 21 is catching women who may have had sex but are not comfortable expressing that they have done so, or may have been forced to have sex against their will and feel shame (i.e. raped, molested) the three year post sex thing also has to do with the natural progression of the virus.

so regardless of which guideline used, the 24 yo reportedly sexually naive woman should still be offered, and encouraged to undergo cervical cancer screening, even with the absence of risk factors.