Cervical Cancer Screening

At one point in time, cervical cancer was one of the leading causes of cancer deaths for women living in the United States.

Thankfully, the number of cervical cancer cases, and subsequently the number of deaths related to cervical cancer, have dropped drastically over the past 40 years due to Pap tests.

However, cervical cancer is still expected to cause approximately 13,240 new cases of invasive cervical cancer as well as 4,170 deaths in the year 2018.

According to the American Cancer Society, “The most common form of cervical cancer starts with pre-cancerous changes and there are ways to stop this disease from developing. The first way is to find and treat pre-cancers before they become true cancers, and the second is to prevent the pre-cancers.”

What is Cervical Cancer Screening?

Cervical cancer screening is defined by the American College of Obstetricians and Gynecologists as a procedure that can “…find changes in the cells of the cervix that could lead to cancer.”

During this screening, a speculum is inserted into the vagina; it is used to open the vagina so that the healthcare practitioner can visualize the cervix and upper vagina. Cells are removed using a brush for the following tests:

  • The Pap tests, which detects abnormal cells
  • The human papillomavirus (HPV) test, which evaluates for the most common high-risk types of HPV

How Often Should Cervical Cancer Screening Be Performed?

An initial Pap test should be performed at age 21. If the results are normal, the next Pap test may be performed in three years.

For ages 30 to 65, healthcare providers may utilize the following tests based on health history:

  • A Pap test only. If results are normal, waiting three years until the next test is indicated.
  • An HPV test only. This is called primary HPV testing. If results are normal, waiting five years until the next test is indicated.
  • An HPV test plus a Pap test. This is called co-testing. If both results are normal, waiting five years until next testing is indicated.

For ages older than 65, it is likely that screening can be discontinued, especially if past tests have been normal and/or part of the cervix has been removed with a hysterectomy.

There are certain women who may require more frequent screening. For example, women with a prior history of cervical cancer, who have human immunodeficiency virus (HIV), who already have a weakened immune system, or were exposed to diethylstilbestrol (DES) during birth may require more frequent Pap tests.

What Does an Abnormal Pap Test Mean?

An abnormal Pap test can be frightening – but it does not necessarily mean that cancerous cells were detected.

Occasionally, a test can show abnormal cells when the cells were actually positive, meaning that the test was a “false-positive.” However, a Pap is also not foolproof – sometimes it can reveal normal cells when abnormal cells are present, meaning that a test was “false-negative.”

Abnormal cells sometimes are just that – abnormal. Occasionally, abnormal cells go back to “normal” on their own, with no treatment. Abnormal cells can also indicate precancerous cells.

However, abnormal results mean that further testing is indicated. Further testing helps to differentiate between high-grade changes and cancerous cells. A colposcopy or cervical biopsy can be performed; if high-grade changes are detected, the cells are typically removed before they become cancerous.

Preventing Cervical Cancer and Pre-Cancers

Of course, one of the easiest things that can be done to prevent cervical cancer and pre-cancer is to simply follow your physician’s recommendations for Pap and HPV testing.

However, there are several other ways to prevent cervical cancer and pre-cancers:

  • If you are a smoker, quit! If you do not smoke – do not start.
  • Get the HPV vaccine.
  • Use condoms.

The Bottom Line…

Although cervical cancer screening may be uncomfortable, it is a quick and easy procedure that can save your life.

American Cancer Society. (2017, October 19). Can cervical cancer be prevented? https://www.cancer.org/cancer/cervical-cancer/causes-risks-prevention/prevention.html

American Cancer Society. (2018, January 4). Key statistics for cervical cancer. Retrieved from https://www.cancer.org/cancer/cervical-cancer/about/key-statistics.html

American College of Obstetricians and Gynecologists. (2017, September). Cervical cancer screening. Retrieved from https://www.acog.org/Patients/FAQs/Cervical-Cancer-Screening

Centers for Disease Control and Prevention. (2018, September 12). What should I know about screening? https://www.cdc.gov/cancer/cervical/basic_info/screening.htm

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