Time To Get Back In The Stirrups: Pelvic Exams Are Not Obsolete

With the news that annual pelvic exams (pap or smear tests, depending on your geography) might not be necessary, women across the world are cheering the end of the stirrups. A year after the American College of Obstetricians and Gynecologists relaxed the exam requirements, a new article in the Journal of Women’s Health suggests they’re “obsolete.”

But, wait, it appears that not everyone is happy with this state of affairs! Georgia Lewis, an expert woman, explains why the cold, duck-bill shaped thing is actually your friend.

At the risk of mixing my internal organs and my metaphors, cervical smears are close to my heart. I’m that annoying friend who harasses her mates to get their annual pap smear. This is because it most likely saved my life.

Australia, my home country, is a nanny state. While this is absurd when it comes to designing boring playgrounds so our kids never scrape their knees, the fervour with which we promote the annual scraping of the cervixes of our women is, frankly, brilliant.

While women in England cannot get a free smear until they’re 25 and women in America, if Planned Parenthood gets completely neutered, will soon be lucky to get a kind word from an OB-GYN let alone an examination, in Australia my experience of my first pap smear at 18 is not unusual. The rule of thumb in Australia is generally the first smear at age 20 or a year after first having sex, whatever comes first.

At the age of 21, I had an abnormal smear. It was CIN-1, the lowest level abnormality, but because it was discovered early, it was sorted quickly. I then had a smear every six months for two years and have had one annually since. For most women in Australia, once you’ve had your first clear smear, once every two years is recommended.

If I had’ve been in the England, where I now live at the ripe old age of 35, I might not have lived to the ripe old age of 35. Here, where the first free smear doesn’t happen until you’re 25, I could have had four years of blissful ignorance and sex — and then a horrible shock when I had my first free test.

To suggest that 30 should be the age for the first smear test is irresponsible and ignores the fact that many a modern woman has more sexual partners than previous generations. It is this same attitude that causes pearl-clutching hysteria at the thought of getting girls vaccinated against the human papilloma virus before they are sexually active. Add the farce that is abstinence-only sex education to the mix (and didn’t that work well, Bristol Palin?) and we have the potential for a women’s health crisis in America.

The cautious approach in Australia works.  In Australia in 2007, 1.9 cervical deaths per 100,000 women were recorded. The figure for the same year in the US is 2.4 deaths per 100,000 women and 7.9 incidences per 100,000. The Aussie incidence rate is higher at 9.1 per 100,000 women but this is largely down to the high rate of awareness and screening — because we catch so many cases early, the mortality rate is low.

If pesky numbers bore you, the only proof I need that early screening works comes via a heartbroken Englishman I came across on Twitter. He lost his wife to cervical cancer that was diagnosed way too late, when she was only 24.

Georgia Lewis is a journalist who lives in London. Contact her here.