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Cervical Cancer Screening

What is cervical cancer?

Cervical cancer is cancer in the cells of the cervix, the part of the uterus or womb that opens to the vagina.

What causes cervical cancer?

A virus, called human papilloma virus (HPV), is associated with almost all cases of cervical cancer. HPV is a common virus which is contracted by having sexual relations with someone who also has been exposed to the virus. Most people with HPV never even know they have it. Frequently, the viral infection goes away without ever causing any symptoms. In other women HPV can cause genital warts or changes in the cells which can progress to cervical cancer. HPV rarely goes on to cause cervical cancer without certain other factors such as smoking, or having an immune system which has difficulty removing the virus.

There are two types of HPV—“low-risk” and “high-risk.” The low-risk HPV infections can cause genital warts. Sometimes, if the high-risk type of HPV does not go away on its own, it may cause abnormal, or pre-cancerous, cells to form. If these abnormal cells are not found and treated, they may become cancer. The goal of cervical cancer screening is to find these early changes in the cells so that they can be treated before cancer can develop.

What are the risks for developing cervical cancer?

You may be at a higher risk if you:

  • Have had more than one sexual partner or have a male sexual partner who has had more than one partner
  • Began having intercourse at an early age
  • Have had certain sexually transmitted diseases (STDs), such as genital warts or are infected with HIV
  • Have a weakened immune system
  • Smoke cigarettes

What are the symptoms of cervical cancer?

Early cervical pre-cancer cells and even cervical cancer cells can often be present but have no signs or symptoms. That is why it is very important to be sure that you are regularly tested and examined for cervical cancer. Call your doctor if you have irregular bleeding either between periods or after intercourse.

Can cervical cancer be treated?

Yes, cervical cancer is treated with surgery, radiation or chemotherapy. You and your doctor can discuss these treatment options and decide the best treatment.

What tests can screen for cervical cancer?

Your doctor can perform a Pap test and/or an HPV test. Remember: No test can absolutely guarantee that you do not have or will not develop cancer of the cervix or any other form of cancer. However, your doctor’s examinations and the appropriate screening tests are fast and relatively accurate ways to find out your risk of cervical cancer.

What is a Pap test?

The Pap test is a simple test used to help find cervical cancer as early as possible. It is the best method for finding changes on the cervix that can lead to cancer. The Pap test also can detect infection and other health problems of the uterus and vagina.

Performing a Pap test is easily done in the doctor’s office. Some cells are gently brushed from your cervix with a tiny plastic spatula or brush. The cells are then specially prepared, usually in a liquid solution called ThinPrep or Surepath, and sent to a lab. There, they will be examined under a microscope to look for any cells that may be pre-cancerous or cancerous.

What is an HPV test?

The same tissue sample can also be tested for HPV (human papilloma virus). This test can detect the high-risk types of HPV that can cause pre-cancerous changes in cervical cells.

Are there special preparations for these tests?

  • Don’t take the tests if you’re having a heavy menstrual period.
  • Don’t douche for 2 days before the tests.
  • Don’t have sexual intercourse for 2 days before the test.
  • Don’t use tampons or birth control foams, jellies, or other vaginal creams or vaginal medicines for 2 days before the test.

How often should I be tested for cervical cancer?

The American Cancer Society (ACS) and the American College of Obstetricians and Gynecologists (ACOG) recommend:

You should have your first Pap test within 3 years after you start having sexual intercourse, or by the time you are 21 years old.

Women under 30 should have a Pap test every 1 to 2 years. HPV testing is often less useful in this age group. Young women may have more frequent HPV infections (which are likely to be temporary) and more frequent changes in sex partners. During these years, when HPV infection and Pap test abnormalities are common, it is recommended that women be screened often (every 1-2 years depending on the type of Pap test and patient preference). Fortunately, in young women, most HPV infections and Pap test abnormalities clear up on their own before the infection causes any cell changes or symptoms.

For women age 30 and older, there are several recommended screening options. Women should discuss these screening options with their doctor.

  1. Screening for cervical cancer using only the Pap test. If a woman age 30 or older has negative results on three consecutive Pap tests, then she may be rescreened for cervical cancer with only the Pap test every 2-3 years.
  2. Screening for cervical cancer using both the Pap test and the HPV test.
    • If both the tests are “negative”, that means you have a very low risk for cervical cancer. You may not need to be tested again for 3 years.
    • If the Pap test is “negative” and the HPV test is “positive”, repeat the Pap test and HPV test in 6 to 12 months.
    • If both tests are “positive”, talk with your doctor about what to do next.
  3. If you are over 70, ask your doctor about how often you need Pap smears.

If you have had a hysterectomy for reasons other than cancer, talk with your doctor about discontinuing Pap tests altogether.

Talk with your doctor about the best screening schedule for you and follow your doctor’s recommendations. Remember: All women should schedule appointments every year with their gynecologist for important examinations including breast and pelvic exams and preventive health recommendations.

Does insurance pay for these tests?

Some insurance companies pay for the Pap test and the HPV test; however, some insurance plans may have certain requirements that the patient must meet, such as an annual deductible. Please check with your insurance company.