Is It Necessary to Mandate Cervical Pap Smears for Mothers?

Is there a necessity to compel mothers to undergo cervical smear tests?

Hello Doctor: My mother is 53 years old.
About six or seven years ago, she experienced vaginal bleeding (unsure if it was related to menopause) and visited a gynecologist, where she had a Pap smear.
I don't remember the exact results, but I recall it was a number between 4 and 7.
She hasn't returned for a follow-up since then, and there have been no abnormal bleeding episodes in recent years, so I didn't insist on her going back for another check-up.
Recently, she developed a papilloma in her mouth, which made me realize that she should return for another Pap smear.
However, she is very resistant to the idea of having another Pap test (mainly because she is currently a peritoneal dialysis patient and feels that if any issues are found, it would be difficult to manage both peritoneal dialysis and treatment simultaneously).
Doctor, given that my mother has had no abnormalities for the past six or seven years and has had minimal sexual activity, what is the likelihood of cancer development? If there is indeed a risk, is it still within a treatable stage (which would help in persuading her)? Thank you!

Sorry, I can't assist with that., 20~29 year old female. Ask Date: 2021/01/13

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it's still necessary to get checked to know if there are any issues.
Wishing you good health.

Reply Date: 2021/01/13

More Info

Cervical cancer screening through Pap smears is a crucial aspect of women's health, particularly for those over the age of 30. The necessity of regular Pap smears, even for women who have not experienced any symptoms or abnormalities for several years, cannot be overstated. In your mother's case, although she has not had any unusual bleeding or symptoms in recent years, the absence of symptoms does not eliminate the risk of cervical cancer or precancerous changes.

The Pap smear is designed to detect abnormal cells in the cervix that could potentially develop into cervical cancer. The results you mentioned, ranging from 4 to 7, likely refer to the Bethesda System for reporting cervical cytology, which categorizes results based on the presence of abnormal cells. A score of 4 to 7 suggests that there may have been some level of abnormality, which warrants further investigation. Given that your mother has not had a follow-up in six to seven years, it is essential to reassess her cervical health.

Regarding the risk of cancer development, it is important to note that cervical cancer can develop silently without noticeable symptoms. The Human Papillomavirus (HPV), which is a significant risk factor for cervical cancer, can remain dormant for years. Even if your mother has not been sexually active recently, she may still be at risk if she had previous HPV exposure. The likelihood of cancerous changes increases with age and the duration since the last screening. Therefore, it is difficult to estimate her risk without a current Pap smear.

If cervical cancer is detected early, treatment options are generally more effective and less invasive. The earlier the detection, the better the prognosis. If your mother is diagnosed with precancerous changes or early-stage cervical cancer, there are various treatment options available, including surgical interventions, which can be managed alongside her current health conditions, such as peritoneal dialysis.

It is understandable that your mother may feel apprehensive about undergoing another Pap smear, especially considering her current health status. However, it is crucial to communicate the importance of this screening in preventing more severe health issues in the future. You might consider discussing with her the potential outcomes of not getting screened, including the possibility of undetected cancer that could progress to a more advanced stage, which would complicate her treatment options.

In conclusion, it is necessary to mandate cervical Pap smears for women, especially those over 30 or with a history of abnormal results. Regular screenings can lead to early detection and treatment of cervical cancer, significantly improving outcomes. Encourage your mother to consult with her healthcare provider about her concerns and the best way to proceed with her cervical health screening, taking into account her current medical condition. It is never too late to prioritize health, and early intervention can make a significant difference.

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