Will Routine Speculum Exams Become a Thing of the Past?


Speculum for a routine pap

As we’ve posted here before, pap smears (cervical cancer screening) used to be something your OB/GYN did once a year. Testing strategies have changed to incorporate Human Papilloma Virus (HPV) testing and decreased the recommended frequency of testing to every 3-5 years depending on your age. Evidence has suggested that HPV testing alone is an acceptable screening method in most patients but what’s not needed is evaluating the cells that are collected during a pap. What is even more interesting is that PATIENT collected specimens (with a simple Q-tip like swab) is as accurate as a specimen collected by a doctor. Several studies have shown this and the British Medical Journal just released a meta-analysis (where several research study results are combined together to improve the power ((accuracy)) of the findings) indicating that self collected swabs are equivalent to doctor collected swabs.

Recommended HPV test


   “When used with hrHPV [high risk HPV] assays based on polymerase chain reaction, testing on self samples was similarly accurate as on clinician samples. Offering self sampling kits generally is more effective in reaching under-screened women than sending invitations… ”


So the question still remains…will routine speculum exams become a thing of the past? Just as patients are sent home to collect samples to screen for colon cancer, there is no reason why patients can’t do the same for cervical cancer screening. Unfortunately, the dreaded speculum exam isn’t going away–there will still be a need to follow up on abnormal HPV screening tests, but we predict that the frequency of these will continue to go down.