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Why Have Cervical Cancer Screening?

Cross section of female pelvis showing hands taking cervical sample for pap test.
A speculum is used to open the vagina so cells can be taken from the cervix.

Cervical cancer starts in a woman’s cervix and can spread to other parts of the body. The cervix is the lower part of the uterus that connects to the opening of the vagina. Early on, cervical changes don't cause symptoms. Often, the only way to know you have cervical changes is to do cervical cancer screening. Screening tests are done to detect possible cancer in people who don’t have any signs of cancer. A Pap test or testing for human papillomavirus (HPV) can find these problems early, when they are easier to treat. Pap tests can also detect some infections of the cervix and vagina.

What is a Pap test?

A Pap test is a procedure that helps find changes in the cervix that may lead to cancer. For this test, a small sample of cells is taken from the cervix with a swab. This is done in your healthcare provider’s office. The cells are then looked at in a lab to see if there are any abnormal cells. A Pap test is a safe procedure. It takes just a few minutes and causes little or no discomfort.

The HPV connection

HPV is a family of viruses that spread through skin contact. Certain types are almost always spread through sexual contact. Some HPV types cause genital warts (condyloma). But not all types of HPV cause visible symptoms. Certain types cause cell changes (dysplasia) in the cervix that could eventually lead to cancer. In fact, HPV infection is the most important risk factor for cervical cancer. Healthcare providers can now test for HPV. Testing for HPV is often done with the Pap test. It’s important to have cervical cancer screenings as recommended by your healthcare provider. This helps ensure that any abnormal cells will be found and treated before they become cancerous. Women in same sex relationships should also be screened for HPV.

Who should have a Pap test or HPV test?

Ask your healthcare provider when to start cervical cancer screening, what types you should have, and how often to have them. Follow these guidelines from the U.S. Preventive Services Task Force for cervical cancer screening:

  • A first Pap test at age 21. And then every 3 years until age 29, HPV testing is not recommended during this time, though it may be done to follow-up on an abnormal Pap test.

  • Starting at age 30, screening in average risk women can be done through a Pap test done with an HPV test (co-testing) every 5 years. This should be done until age 65. Another option for women in this 30 to 65 age group is to have just the Pap test done every 3 years or screen every 5 years with high-risk HPV testing alone.

  • You may need a different screening schedule if you are at high risk for cervical cancer. Risk factors include having HIV, a weak immune system, being on long-term steroids, or exposure to the medicine DES while your mother was pregnant with you. Talk with your healthcare provider about the best schedule for you.

  • If you’re over age 65 and have had regular screenings for the last 10 years with no abnormal results in the last 20 years, the U.S. Preventive Services Task Force doesn’t recommend screening unless you are at high risk for cervical cancer.

  • If you had a hysterectomy that included removing your cervix, you can stop screening unless the hysterectomy was done to treat cervical cancer or pre-cancer. If you still have your cervix after the hysterectomy, you should continue screening according to the above guidelines.

  • Routine testing does not need to be done each year. However, if your test is abnormal, your healthcare provider will let you know how often to be tested. 

  • Women who have been vaccinated for HPV should still follow these guidelines.

  • If you have had cervical cancer, talk with your healthcare provider about the follow-up plan that's best for you.

Feeling anxiety during visits with your healthcare provider is not uncommon. This is especially true if you have a history of trauma. Tell your healthcare provider if you are anxious about your visit. Work together to find ways to reduce your anxiety. Talk with your mental health team about issues that bother you. If you don’t have a mental health provider, talk with your primary healthcare provider about your concerns. Ask for an appointment to speak with a mental health provider.

Author: StayWell Custom Communications
Last Annual Review Date: 6/1/2019
Copyright © The StayWell Company, LLC. except where otherwise noted.
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