最晚21岁，需要一种对自己负责的态度
美国有说法称，年轻女性在最晚21岁的时候必须做一次巴氏涂片检查,并且最好每年检查一次。那么最早在什么年龄进行这类检查最佳呢？原文记者就此采访了梅奥医学中心，探讨青少年女性的妇科检查问题。
并非所有青春期女性都需要妇科检查
Gynecological exams not necessary for all adolescent girls
DEAR MAYO CLINIC: At what age should a teenage girl have her first Pap smear and gynecologic exam? Should this be done by a pediatrician or another provider?
请问梅奥医学中心：青春期女性应该在什么年龄进行第一次巴氏涂片（译者注：一种宫颈防癌筛查）和妇科检查？
ANSWER: Pelvic exams and Pap smears are not necessary in healthy, adolescent girls who are not sexually active and who do not have gynecologic symptoms or other concerns. The recommended age for young women who have not previously needed a Pap smear to begin having the test is 21. Primary care providers, such as those in family medicine or internal medicine, can perform that exam, or a gynecologist can perform the exam.
答：对于健康、性生活不频繁、没有妇科疾病症状及其他问题的青春期女性来说，盆腔检查和巴氏涂片不是必需的。年轻女性推荐在21岁时进行第一次巴氏涂片检查。从事家庭医学、内科等基本保健服务或妇科研究的女性，也可以进行这项检查。
In the past, many health care providers used to recommend that teens have a Pap smear at 16 or 18. Now, however, the American College of Physicians does not recommend any routine gynecologic exams for teens at low risk of having the HPV or other sexually transmitted infections.
过去，许多医护人员都建议青少年在16岁或18岁时进行巴氏涂片检查。但如今，美国医科大学却并未建议任何HPV或其他性传播感染患病风险较低的青少年进行常规妇科检查。
The purpose of a Pap smear -- a procedure that collects cells from the cervix -- is to check for changes in those cells that could be a sign of cancer and look for the presence of high-risk types of HPV that are known to cause cervical cancer.
巴氏涂片——一种从子宫颈部取得细胞样品的检查，其目的是为了检查是否有细胞存在癌变的征兆，并查找已被证明能导致宫颈癌的高危型HPV的存在。
HPV is the most common sexually transmitted infection in the U.S. Although most cases of HPV do not cause symptoms or lead to problems, certain strains of the sexually transmitted HPV are considered high risk, and can lead to cancer and potentially be deadly if left untreated. Two strains of the virus cause 70 percent of all cervical cancer. You can greatly reduce your risk of HPV infection and cervical cancer by getting the HPV vaccine. This anti-cancer vaccine most effectively builds immunity when it's given between ages 9 and 14.
HPV是美国最常见的性传播感染病毒。尽管大多数HPV不会引发疾病症状或产生系列问题，但某些性传播的HPV病毒株仍被视作是高风险和易致癌的，如果不及时治疗甚至可能致命。两株病毒引发宫颈癌的概率能达到70%。通过注射HPV疫苗，可以大大降低HPV感染和宫颈癌的风险。这种抗癌疫苗在9岁至14岁之间注射时能最有效地建立免疫力。
If you are not sexually active as a teen, in most cases there is no need for a Pap smear because your risk of cervical cancer is low, and you have no risk of HPV or other sexually transmitted infections. Once you begin having sex, a Pap smear may be appropriate. But even in many of those situations, Pap testing still may not need to begin until 21.
作为一名青少年，如果你的性生活并不活跃，在大多数情况下，你并不需要进行巴氏涂片检查，因为你患宫颈癌的风险性很低，也几乎没有患上HPV或其他性传播感染疾病的风险。当你开始性生活后，进行巴氏涂片检查或许是合适的。但即便如此，大多数情况下也无需在21岁之前进行巴氏涂片检查。
Traditionally, some health care providers required a pelvic exam -- an evaluation of the vulva, vagina, cervix, ovaries, uterus, rectum and pelvis for any abnormalities -- before they would prescribe contraceptives. Again, that is no longer the case. A pelvic exam is not needed to obtain birth control. For most healthy women, the first pelvic exam also can wait until 21.
按照传统惯例，一些医护人员会提供盆腔检查——评估外阴、阴道、子宫颈、卵巢、子宫、直肠和骨盆的异常情况，然后再开具避孕药物。同样，如今情形也发生了改变，盆腔检查不再成为节育的必需。对于大多数健康女性来说，第一次盆腔检查也可以等到21岁再做。
For young women whose medical history puts them in a higher risk category for infection or cancer, a Pap smear or pelvic exam may be recommended at an earlier age. Those risk factors include a weakened immune system due to chemotherapy, organ transplant or long-term corticosteroid use; exposure to the medication diethylstilbestrol, also known as DES, before birth; and HIV infection.
对于具有高风险感染或癌症患病几率病史的年轻女性来说，她们最好在更早的时间段内进行巴氏涂片或盆腔检查。这些风险因素包括由于化疗、器官移植或长期使用皮质类激素导致的免疫系统减弱，胎儿期处于己烯雌酚（即DES）的药物环境中，以及HIV感染。
Some symptoms also may trigger a pelvic exam, such as heavy, painful periods; pelvic pain or pressure; abnormal bleeding or discharge; and itching, pain or lesions in the vulva or vagina. In those situations, a pelvic exam may be necessary, but a Pap smear typically is not required.
有些症状也可能适合进行盆腔检查，比如经期疼痛、骨盆疼痛或压力、异常出血或排泄、以及外阴或阴道部位的瘙痒、疼痛或病变。在这些情况下，盆腔检查可能是必要的，但通常不需要巴氏涂片检查。
When it is time to get a pelvic exam and Pap smear, it's best to work with a health care provider you know and trust. Before the exam, ask your health care provider about what will happen during the exam and what you can expect. Some providers have anatomical models they can use to describe the procedures beforehand, so you can clearly see what will happen. These procedures are important exams, but they need not be a source of anxiety or fear. If you have questions or concerns, talk to your health care provider.
当进行盆腔检查和巴氏涂片检查的时候，最好和你认识和信任的医护人员合作。检查前，向医护人员咨询清楚在检查期间会发生什么，以及你能获得什么。有些医护人员会提供用来描述过程的解剖模型，由此你能清楚地看到会发生些什么。这些程序都是检查的重要部分，但它们无需成为焦虑或恐惧的来源。如果你有问题或顾虑，请与你的医护人员进行沟通。
-- Sally Ann Pantin, M.D., Family Medicine, Mayo Clinic, Jacksonville, Fla.
——莎莉 ·安 ·潘汀，佛罗里达州 杰克逊维尔市 梅奥医学中心 家庭医学博士
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