Understanding Cervical Cancer Screening
What is Cervical Cancer?
Cervical cancer occurs in the cervix, the lower part of the uterus that opens into the vagina. It develops when cells in the cervix become abnormal and grow uncontrollably, potentially spreading to other parts of the body.
How Cervical Cancer Occurs
Most cervical cancers are caused by Human Papillomavirus (HPV), a common virus transmitted through sexual contact. Persistent infections with high-risk HPV types can lead to severe changes in cervical cells and, if untreated, to cancer.
The Importance of Cervical Cancer Screening
Screening is vital because it can detect changes in cervical cells before they turn into cancer. Early detection through screening can lead to effective treatment, significantly lowering the risk of developing cervical cancer.
How Screening is Done
Cervical cancer screening can include a Pap test, an HPV test, or both. These tests involve collecting cells from the cervix during a pelvic exam using a speculum and a brush or other sampling tool. The cell samples are then sent to a lab to check for abnormalities or the presence of high-risk HPV types.
Who Should Get Screened and When
(These guidelines apply to anyone with a cervix regardless of sexual identity, these individuals will be referred to as Female)
- Females aged 21 to 29: Recommended to have a Pap test every three years. At 25 years and older a HPV test will be performed in addition or substitution to a pap test.
- Females aged 30 to 65: Can choose between a Pap test every three years, a HPV test every five years, or both tests together every five years (co-testing).
- Females over 65: May stop screening if they have had regular screenings with normal results for several years, or if they have had their cervix removed as part of a total hysterectomy for non-cancerous conditions.
- Females with higher risk factors: Those with a history of cervical cancer, a weakened immune system, or exposure to DES (also known as Diethylstilbestrol), a synthetic estrogen once prescribed to prevent pregnancy complications but later found to cause health issues in children of women who took it, may need more frequent screening.
Frequently Asked Questions
- Why is screening not recommended before age 21? Cervical cancer is extremely rare in this age group. Research shows that screening does not reduce cervical cancer rates in young women under 21.
- Why isn’t yearly screening recommended? Research shows that less frequent screening (every three years) prevents as much cancer as yearly screening but with fewer unnecessary procedures and less harm.
- Why is screening still recommended if I am not having sex? In rare cases, HPV can be transmitted by non-sexual means, and not all cervical cancers are caused by HPV.
- Why is co-testing not recommended for women under 30? HPV infections are common in this age group but are usually transient (will clear on their own). Co-testing could lead to unnecessary treatment and anxiety.
- Are these guidelines likely to change? Yes, guidelines may evolve as new research and technology develop. Please ask your provider if you have questions about the guidelines.
- Do I still need to see my ob-gyn every year if yearly cervical cancer screening is no longer recommended? Yes, regular health visits are important for discussing other aspects of gynecologic health, this visit is not just for cancer screening.
- If I am in a same-sex relationship do I still need cervical cancer screening? Yes, there is higher risk of HPV infection with same-sex relationships and– regardless of your relationship– if you have a cervix you need screened.
- Can I get a Pap test while I am on my menstrual period? Yes, you can get a Pap test during your period. Our office may offer to schedule you for a different time if you are having problems with vaginal discharge as the blood may interfere with results testing the discharge.
- What if my HPV test is positive?
- HPV is the most common STI, many people who have sex get this at one point in their lifetime. Many times HPV goes away or remains undetected at a low level.
- If your HPV test is positive and you did not have a Pap test, then this will likely be performed or if possible added onto your HPV testing.
- There are multiple strains of HPV, only some are at-risk for cervical cancer.
- Remember if you have had an abnormal result before to let your provider know, this helps determine what we need to do when we get an abnormal back.
- Practicing safe sex with oral, vaginal, and anal sex such as using a condom or dental dam helps lower the chances of spreading HPV to your partner(s).
- You can consider vaccination if you have not already received the most recent HPV vaccine to cover and prevent new infections from some of the other HPV strains
What Happens if Screening Results are Abnormal?
Abnormal results do not mean you have cancer. They indicate that further testing is needed to determine the presence of high-grade changes.
Options may include:
- Repeat pap testing
- Colposcopy – a special exam to look at the cervix
- Biopsy to examine the cells more closely
- Treatment to remove abnormal cells may be necessary based on these results