Many teenage girls do not know the difference between a Pap smear and a pelvic exam, and this confusion could lead them to put off necessary gynecologic care, according to researchers. Pap smears are performed as part of pelvic exams to test for early signs of cervical cancer. But pelvic exams are also necessary for detecting STDs and other gynecologic problems.

The fact that many young women might not understand the distinction is a concern because new American Cancer Society guidelines state that women can delay their first Pap until a few years after becoming sexually active. So some young women may end up thinking that they need no gynecologic care during that time, said study author Diane R. Blake. HPV infections that become cancerous typically do so when a teenager gets a little older, she said. "The Pap smear to them is the whole gynecological exam, so they're thinking they don't need gynecological care for a few years after having sex," Blake said. The reason for recommending the initial delay for a Pap smear is that doctors see so little cancer in this age group, said Blake.

Blake and colleagues at the University of Massachusetts Medical School-Worcester surveyed 110 females, ages 14-24, and 44 mothers, asking them to define "Pap smear" by choosing from a list of descriptions. They were looking to see whether respondents knew that a Pap smear is the same as a cervical cancer test, but not the same as a pelvic exam, pregnancy test or STD test. They found that only 2 percent of the young women understood these distinctions. Overall, 70 percent said they were sexually active. Of the mothers, about half correctly defined what a Pap smear is. The study, "Adolescent and Young Women's Misunderstanding of the Term 'Pap Smear,'" was presented at a meeting of the Society for Adolescent Medicine in Seattle in March.

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