All women who have ever had sex need to have a regular Pap test, but the rules about when to start having Pap tests, how often to have them and when to stop having them, have changed. “Regular Pap tests are still the best protection against cervical cancer — preventing up to 90 per cent of deaths from the disease,” said Dr. Robert Grimshaw, medical director, Cancer Care Nova Scotia’s Cervical Cancer Prevention Program. “Until recently, we recommended annual Pap tests for all women as soon as they became sexually active. The new guidelines, by contrast, are very individual and depend on the results of a woman’s previous Pap tests. However, the changes in no way lessen the importance of regular Pap tests.” This message and details about the new guidelines were shared today, Oct. 19, in Halifax during the launch of Pap Test Awareness Week, Oct. 22 to 28. The new guidelines say: — Women should begin having Pap tests within three years of first vaginal sexual activity or at age 21. This vaginal sexual activity includes vaginal intercourse, vaginal-oral and vaginal-digital sexual activity and use of shared sex toys/devices. — If it has been more than five years since a woman has had a Pap test, she needs to have three yearly Pap tests in a row, until there are three consecutive negative test results. Then, she can have a Pap test every two years. — Women who are on the birth control pill and who have had three consecutive annual negative tests should have a Pap test every two years. — Women who are in a same sex relationship should have regular Pap tests. — Pregnant women should have Pap tests according to the same guidelines as women who are not pregnant. — Women may stop having Pap tests at age 75 only if they have an adequate negative screening history over the previous 10 years (at least three negative tests). — Women who have undergone a total hysterectomy (removal of the uterus and cervix) and who have no history of cervical dysplasia/cancer, probably do not need to have Pap tests. If they are uncertain, they should check with their health-care provider. “We know that Pap test can save lives and do,” said Health Minister Chris d’Entremont. “These new guidelines reinforce that and place even greater emphasis on why it’s important for women to get one.” A group of cancer specialists, family doctors and others worked with the Cervical Cancer Prevention Program to develop the new guidelines. They reviewed the existing guidelines, which had been in place since the program was established in 1991. They also assessed guidelines of other screening programs, researched evidence about the development of cervical cancer, and studied Nova Scotia’s cervical cancer statistics. “I recently told a patient that doing Pap smears are a bright light in my day. As a doctor, I would far prefer to see a woman for a procedure like this when we have a 95 per cent chance of preventing a horrible illness,” said Dr. Rhonda Church, president of Doctors Nova Scotia. “Like many doctors, I often suggest to women that they plan to have their Pap test during their birthday month. That way, it’s easy to remember and they can consider it a gift to themselves and the people who care about them.” The new provincial guidelines recommend that all women who have ever had sex have regular Pap tests. Women are encouraged to speak with their family doctor or health-care provider about what ‘regular’ means for them. They may also call the Cervical Cancer Prevention Program at 1-888-480-8588 to find out more about Pap testing or to learn about the results of their previous Pap tests. “This year it is estimated that every week, one woman in Nova Scotia will be diagnosed with cervical cancer,” said Maureen Summers, executive director of the Canadian Cancer Society – Nova Scotia Division. “The rules have changed, but one thing remains the same, prevention and early detection are key, especially when you consider that at least 50 per cent of cancers can be prevented through healthy living and policies that protect the public. This includes following cancer screening guidelines, such as having a regular Pap test.” Each year during Pap Test Awareness Week, Cancer Care Nova Scotia’s Cervical Cancer Prevention Program partners with community groups and organizations, including the Department of Health, Doctors Nova Scotia, the Canadian Cancer Society – Nova Scotia Division, and the Nova Scotia College of Laboratory Technologists, to raise awareness about the benefits of regular Pap tests. Over the next two weeks, information about Pap tests and the new guidelines will be shared with women throughout Nova Scotia through print and radio advertisements, and informational brochures. Cancer Care Nova Scotia’s Cervical Cancer Prevention Program is dedicated to reducing the incidence of cervical cancer in Nova Scotia. Strategies are aimed at educating women about the importance of regular Pap tests, and putting measures in place to support women taking appropriate action. Cancer Care Nova Scotia is a program of the Department of Health, created to reduce the burden of cancer on individuals, families and the health-care system through prevention, screening and research. It also aims to lessen the fear of cancer through education and information. Its programs are community-centred, compassionate to patients, cost-effective and based on sound research. The Department of Health, through leadership and collaboration, works to ensure an appropriate, effective and sustainable health system that promotes, maintains and improves the health of Nova Scotians. Doctors Nova Scotia is the professional association that represents more than 3,000 physicians, medical students and residents in the province. The association works with other health-care organizations to enhance the quality of medical care for Nova Scotians through health promotion, development of health-care policies, medical education and negotiations with government on behalf of its members. The Canadian Cancer Society – Nova Scotia Division, is a community-based, non-profit organization that partners with communities to overcome cancer and create healthier lives for all Nova Scotians. The society achieves its mission through research, programs that bring help and hope to people affected by cancer, and prevention initiatives that help people reduce their cancer risk. Women should have three yearly Pap tests in a row. If all three of those tests are negative (normal) they only need to have a Pap test every two years, unless: they have ever been treated (by LEEP, laser, conization, cryotherapy, cautery, or hysterectomy) for cervical dysplasia or cancer of the cervix or they are immuno-suppressed (HIV positive, transplant patients). These women should have yearly Pap tests for life.