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Elaine Brown, MD  
Female, 52
Billings, MT

Specialties: Pregnancy, Gynecology

Interests: obstetrics & gynecology, Gynecology
Elaine Brown, MD - BLOG
gynecology
(406) 252-0022
Billings, MT
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Pap Smears and Hpv:  New Guidelines from the American Society for Colposcopy and Cervical Pathology

Sep 07, 2012 - 4 comments
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pap smears

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HPV

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Cervical dysplasia

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Cervical Cancer

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new guidelines for pap smears

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pap smear and hpv testing

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hpv and cervical cancer

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hpv causes cervical cancer



The pap smear was introduced in the 1960's in the United States, and since that time, the rate of cervical cancer has decreased dramatically.
Last year in the US there were only 12710 new cases. Most new cases now are diagnosed in women who have not had recommended screening
either because of lack of access or personal preference.

At the time pap smears were introduced, the decision to perform them annually was completely arbitrary.  Because it was a new test, no one knew
how often it should be done.  Since that time, much has been learned about what causes cervical cancer. We now know that ninety-nine percent of
cervical cancers are caused by high risk types of the human papilloma virus.  We have also learned a lot about the natural history of the human papilloma virus.
In fact, the majority of cases of hpv will be transient, in other words the patient's own immune system will successfully fight the virus so that the infections remain insignificant
and never lead to precancerous or cancerous disease.   In fact if we test too often, we will end up doing unnecessary procedures on women who will "get well"
on their own without intervention.

In addition, we now have  new medical technology that allows testing of cervical samples for the presence
of the hpv virus.  Using the two tests (pap and hpv) together permits earlier diagnosis of precancerous conditions in women with positive tests, and in turn, permits
women with negative test results to go longer in between screenings.

Because of all this new knowledge and insight, the American Society for Colposcopy and Cervical Pathology now recommends the following screening:

For Women under 21:  No testing
For Women aged 21-29: testing with cytology (pap smear) only, every 3 years
For Women aged 30-65: Co testing with cytology(pap smear) and hpv testing every 5 years
For Women aged 65 and above, or after hysterectomy for benign (non cancerous) disease:  discontinue testing

These recommendations are quite a radical departure from the previous yearly pap smears that many women were used to do, but the science indicates that
this testing will be frequent enough to permit detection of cervical cancers and pre cancers, but not enough to result in unnecessary procedures that can lead
to other complications.
The new guidelines are sure to come as a surprise (and probably a pleasant one) to many women.

For more information go to www.asccp.org

Comments
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by JustSara, Sep 08, 2012
What type of exam should a woman of 52 get from her GYN?  I have just stopped menses for 9 mo now.

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by nell615, Sep 09, 2012
Im 26 and I been having the virus for 3 years but I dont have any systoms...They just know I have the virus..so will I ever get rid of the virus? Will that affect me having kids?

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by PinkyBtw, Jun 24, 2013
Hey Im 19 Years Old And I Did The Deed 6/6/13 He Came In Me Had A Light Unusual Light Bleeding 6/7/13 For 5 Days Went To The Hospital 6/9/13 Had A UTI For 3 Days My Period Was Suppose To Come 6/17/13 But It Hasn't Came Down Yet I Feel Bloated My Lower Back Hurts From Time To Time Im Cramping Like Crazy But Still No Blood What Could This Mean ? Could I Be Pergnant ? Please HELP ME SOMEONE

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by gatorguyinfla2, Jul 15, 2013
Greetings Dr. Brown,

My wife and I have been battling HPV for the last 2 years and last year we had to go through a Conization and after waiting the mandatory 6 months we received a clean bill of health and started trying to get pregnant with our second before the Atypical cells reappeared. Anyways,we got pregnant almost two months ago and received a clean pap and now we received results back today and BAM....the Atypical cells have resurfaced. We are going to see our Gynocologist / Oncologist next week to conduct a Colposcopy to make sure what exactly we are or will be dealing with at this point in time. My only questions is....should we go through with the Colposcopy and another Conization if it is suggested or just wait until our baby is born before we do anything? My only concern is if it is precancerous and they want to do something than they wouldn't be able to do anything until the baby was born....I dont think another 6 months is going to change anything, right? Please let me know...for I would certainly appreciate your input...

Chris

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