Going to the doctor once a year is an important part of preventative health care.  The CDC (Centers for Disease Control and Prevention) recommends that all adults receive preventative care to help prevent illness, disease and other health problems, as well as detect illness in its earliest stages for better treatment options. Women should visit their gynecologist once a year for an annual exam.

What Happens at the Annual Exam?

The doctor will conduct a physical exam.

• Blood Pressure.

• Weight.

• Pap Smear. Women ages 21 to 65 should have a pap smear done every three years.  If a previous pap test had abnormal results, this test may need to be done more often.  The doctor takes a sample of cervical cells to screen for cervical cancer.

• Breast Exam. The doctor will perform a breast exam to detect any lumps or abnormalities.  He will do this once a year.  Every woman should also conduct self breast exams regularly.

• Mammogram. Women may begin to get mammograms when they turn 40.  Recommendations differ so it is important to discuss this with your doctor.  If you have a family history of breast cancer, it may be necessary to begin screening earlier.  Anytime a lump is found, a mammogram will be ordered regardless of your age.  The doctor will give you an order for a mammogram if he believes it is necessary.  You will schedule the mammogram at the hospital.

Abnormal Pap Smear Results

An abnormal pap result doesn’t mean that you have cancer.  Abnormal cells were found that could be caused by cancer or an infection.  In order to determine whether a more serious issue is present, it is important to do a colposcopy and biopsy.  This procedure will determine if the cells are cancerous and if more steps need to be taken.  Possible abnormal pap results include:

• SIL. SIL stands for squamous intraepithelial lesion, and means that you have dysplasia.  Dysplasia is the growth of abnormal cells on the surface lining of your cervix or the endocervical canal, which is the opening between the uterus and the vagina. These are precancerous cells that may develop into cancer in the future. This doesn’t mean you have cancer. A colposcopy and biopsy will be done to determine the extent of the dysplasia and whether there is cancer.
• LSIL. LSIL stands for low grade squamous intraepithelial lesion.  If your pap indicates LSIL, it means you may have mild dysplasia.The next step is to have a colposcopy and biopsy to determine the extent of the dysplasia and whether it is cancerous.
• HPV. HPV is a virus that most people come in contact with.  While it can be transmitted sexually, it can also be transmitted skin to skin and transferred to the cervix.  In most cases, the immune system clears the infection.  A few strains of HPV are associated with cervical cancer.  This doesn’t mean you have or will get cancer.  However, if you have a normal pap, with HPV present, it is important to return in one year for a repeat pap to monitor the situation.  If your pap is abnormal with HPV present then it is important to do a colposcopy and biopsy to determine if there is anything to be concerned about.
• ASC-US. ASC-US stands for atypical cells of undetermined significance.This means there are mildly abnormal cells of the cervix from an unknown cause.  Once again, this result does not necessarily mean the cells are abnormal from cancer.  They can be abnormal from an infection.  However, it is important to have a colposcopy and biopsy to determine if the cells are benign.
• ASC-H. ASC-H stands for atypical squamous cells.  This means a high-grade lesion may be present.  A colposcopy and biopsy are needed to determine the extent of the problem.

What is a Colposcopy?

The colposcopy is a procedure done in the doctor’s office.  The doctor will use a special magnifying device to take a closer look at your vulva, vagina and cervix.  He will also take a small tissue sample called a biopsy, that he will send to the lab to get tested.  This procedure is done when a pap result is abnormal.

• Benign results. The biopsy may show that there are no abnormal cells.  If you have a benign result, no treatment is needed.  Return for your annual exam to continue screening for problems.

• Abnormal results. The biopsy may show that there are precancerous or cancerous cells. Depending on the exact result, you may need to have the abnormal cells monitored or removed.  The doctor will discuss your options with you.

My Annual Exam and My Insurance

Many insurances will cover an annual exam one time per calendar year.  It is important to talk to your insurance to discover what is covered and how often you can be seen.  Your visit may not be covered if you come in too soon for your exam.  Check with your insurance for your coverage and benefits.