All the talk about HPV lately has some of my patients wondering: If I don't have multiple sex partners, I should be safe, so why do I need to get a Pap test every year? Well, D. is the perfect example of why.  D. works at my hospital and is beloved by all who know her. After years of putting off Pap smears, she got one shortly after the birth of her third child. Shockingly, it came back cancer. Not precancerous-cells, needs-close-follow-up, but the real thing.  
How does this happen to a healthy 38-year-old who actually works in a hospital? No one likes to go for Pap tests, even those of us with easy access to care and good insurance to boot. And D. has been married for a decade with very few other lifetime partners. She didn't think she was really at risk of cervical cancer. Yes, most cervical cancer is linked to the sexually transmitted HPV, but not the kind known as adenocarcinoma, which is D.'s type of cancer. 

We don't know what leads to this form of cancer, but we know the HPV test wouldn't have helped her. So even if you're married or monogamous (and your partner is too), you need Pap tests to pick up the types of precancerous changes that aren't sex/HPV related. Bottom line: We all need Pap tests, most of us every two to three years, until we're 70 years old. (There's nothing particularly magical about that age, it's just that cervical cancer is so slow-growing that if precancerous cells haven't shown up by then, we're more likely to die of other diseases, so don't need the screening anymore.)

D. is young, but even younger women can get cervical cancer. D. had major surgery (called a radical hysterectomy) and multiple rounds of chemo, but the cancer hasn't gone away. Her prognosis is dismal, so D. is struggling to enjoy the time she has left with her husband, her kids. She tells all the female visitors to her hospital room, "Make sure you get your Pap tests!" It's a simple reminder, but such an important one. When was your last Pap?