Cervical Cancer Facts

When Should I Get a Cervical Cancer Screening Test?

The American College of Obstetricians and Gynecologists (ACOG) say that

Beginning at age 21. Cervical cancer screening should begin at age 21 years (regardless of sexual history). Screening before age 21 should be avoided because women less than 21 years old are at very low risk of cancer. Screening under age 21 may lead to unnecessary and harmful evaluation and treatment.
Ages 21 – 29. Cervical cytology screening (Pap tests) is recommended every 2 years for women between the ages of 21 years and 29 years. Evidence shows that screening women every year has little benefit over screening every other year and may lead to unnecessary treatment.
Ages 30 – 65. Women aged 30 years and older who have had three consecutive negative cervical cytology screening test results and who have no history of CIN 2 or CIN 3, are not HIV infected, are not immunocompromised, and were not exposed to diethylstilbestrol in utero (DES) may extend the interval between cervical cytology examinations to every 3 years.
Co-testing using the combination of cytology plus HPV DNA testing is an appropriate screening strategy for women older than 30 years. Any low-risk woman aged 30 years or older who receives negative test results on both cervical cytology screening and HPV DNA testing should be rescreened no sooner than 3 years.
Ages 65 -70+. Women who have had 3 or more normal Pap test results in a row and no abnormal test in the last 10 years and are 65-70 and older don’t have to get a Pap test again. Since there has not been a lot of research on the risks that older women have of getting cervical cancer, it is best to talk to your health care provider to decide the best testing schedule for you.
For all ages. Both liquid-based and conventional methods of cervical cytology (Pap tests) are acceptable for screening for cervical cancer.
In women who have had a total hysterectomy for benign indications and have no prior history of high-grade CIN, routine cytology testing (Pap test) should be discontinued.

CURRENTLY, ALL THESE GUIDELINES APPLY FOR WOMEN WHO HAVE BEEN VACCINATED AGAINST HPV, AS WELL AS THOSE WHO HAVE NOT BEEN VACCINATED.

What’s New in Cervical Cancer Screening?

Liquid-based Pap Test

Liquid-based cytology refers to a new way to process Pap test results. Instead of spreading the sample on a glass microscope slide, the cervical cells are placed in liquid in a small bottle. Some of the liquid is placed on a slide and then examined under a microscope.

Research has shown that liquid-based Pap tests can be more accurate than the conventional way of preparing the slides because blood and mucous are removed, making the cells easier to see. Pap testing using the liquid-based method of slide preparation is somewhat more expensive, and so some clinics may not have this option available. Other clinics or health care providers use only the liquid-based method.

Both the American Cancer Society and the American College of Obstetricians and Gynecologists say that both conventional and liquid-based methods are effective cancer screening options. The important thing is to get tested.

HPV Tests.

For women 30 or older. The Food and Drug Administration (FDA) has approved an additional way to test for cervical cancer in women 30 and older. The ACS and ACOG state that this combined test is a reasonable option for screening women over 30. The test combines an FDA approved HPV test and a Pap test. Together these tests help a woman’s health care provider find the cancer-causing or high-risk HPV, along with screening for pre-cancer changes in the cells. Women in this age group may also choose to have a regular Pap test without an HPV test.

If the HPV test is performed along with a screening Pap test, the results will fall into one of the categories below:

If the results of both the Pap and HPV tests are negative (normal), you won’t need to be tested again for 3 years.
If the Pap test is negative (normal) 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.

For women under 30. Women under the age of 30 should not get the combined test. HPV testing is not helpful in this age group. Pap tests, however, are very important at this time of life. Young women 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 every 2 years. 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. Vaccines are now available for girls/women ages 9-26.

Why Should I Be Screened for Cervical Cancer?

A woman who is dying of cervical cancer recently said “I just didn’t get it... I wish that I’d known more.” With over 11,000 cases of cervical cancer each year in the United States, it is clear that she is not alone. Each death from cervical cancer is a tragedy—a tragedy made worse by the fact that most cases are preventable.

Vaccines may prevent nearly 70% of cervical cancer and are available for females ages 9 to 26. The vaccine plus the Pap test and HPV test work together to effectively fight what used to be the number one cause of cancer death in women in the US and still is a major cause of cancer death worldwide.

Hopefully you do not know anyone who’s had cervical cancer—that’s not because the disease has gone away—the virus (HPV) that causes the cancer is as prevalent as ever. Early vaccination and regular screening can make the difference between life and death.

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