Patient Education

Billings OBGYN

Your Health, Our Passion

Over the years, we’ve seen many advancements in women’s healthcare. These advancements and the resulting changes in recommendations for women have sometimes resulted in confusion. One area that is important for women is an annual well-woman exam. You can learn more about well-woman exams here. While the well-woman exam will cover many areas of your health it is important to have an in-depth discussion with your provider about your family history. Your family history can have a large impact on how often and what types of exams are recommended for your health.

Recent changes in the recommendations affect breast cancer screening, Pap Smears, and HPV testing. As well, these guidelines and recommendations continue to be updated as more and more research is done. It’s important to communicate with your doctor during your annual exam regarding your risk factors and what screening and tests you may need.

One area of confusion for women is how often to have Pap Smear and HPV tests done. The current guidelines from The American College of Obstetricians and Gynecologists recommend the following:

  • Women aged 21-29 should have a Pap test alone every 3 years. HPV testing is not recommended.
  • Women aged 30-65 should have a Pap test and an HPV test, also known as co-testing, completed every 5 years. As well, a Pap test alone can be done every 3 years.
  • Women over the age of 65 should stop having cervical cancer screen as long as the following are true:
    • You do not have a history of moderate or severe abnormal cervical cells or cervical cancer.
    • You have had three negative Pap test results in a row or two negative co-test results in a row over the past 10 years, and the most recent test performed within the last 5 years.

These recommendations do not apply to all women and it’s important to have a discussion with your doctor regarding screening. For example, women with HIV weakened immune systems, or those exposed to diethylstilbestrol (DES) before birth may require more frequent screening. Also, women who have been vaccinated against HPV still need to follow the screening recommendations for their age group. Use the following links to learn more about cervical cancer screening and HPV.

In addition to cervical cancer screening, it is important for women to understand the guidelines around breast cancer screening. Current recommendations from The American College of Obstetricians and Gynecologists recommend the following:

  • Mammography screening every 1-2 years beginning at age 40 and no later than age 50.
  • Clinical breast exams should be done every 1-2 years for women aged 25-39 years.
  • For women 40 and older, clinical breast exams are recommended every year.

These recommendations are for women with an average risk of breast cancer. Women at high risk including those with a family history of breast cancer, ovarian cancer or other inherited types of cancer; BRCA1 and BRCA2 mutations; chest radiation treatments at a young age; and a history of high-risk breast biopsy results should talk with their doctor as screening recommendations might be different. It’s also important for women to take an active role in breast cancer screen with breast awareness and self-breast exams.

It’s also important for women to realize that the internet is a source of misinformation and incorrect guidelines that can be unhelpful and even dangerous to women. Unlicensed and poorly educated individuals can share their “recommendations” about women’s health without any sort of oversight online. Studies have found that websites such as personal blogs only provide accurate information 30.9% of the time. In fact, even sites from government organizations were found to be accurate 80.1% of the time.

It is best to avoid the internet when researching symptoms or looking for medical advice. Incorrect information can be worse than no information at all. If you are going to look for information online it’s best to use websites that end in .gov or .state as these are often more accurate and reputable sources.

However, Billings OB-GYN recommends you instead raise concerns and talk with your doctor. Please feel free to contact our office between 8:30 am and 5 pm, Monday through Friday.  We have a registered nurse available to answer questions and address problems you may be experiencing.  Questions regarding recommended guidelines will be directed to your physician for his/her recommendations or you can schedule an appointment to be evaluated.

Dr. Chimene Dahl (MD), Billings OB-GYN Associates