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Screening for Cervical Cancer
The purpose of screening is early diagnosis and treatment. Screening tests are usually administered to people without current symptoms, but who may be at high risk for certain diseases or conditions.
The number of new cases and deaths due to cervical cancer is decreasing each year. Experts agree that this is due to early detection and treatment. Early detection and treatment are possible due to the widespread availability and use of cervical cancer screening methods—the
human papillomavirus (HPV) test
This test is performed in a doctor’s office. You will change into a dressing gown and lie back on the examination table. There will be stirrups at the end of the table where you can rest your feet. The doctor may complete other aspects of a physical exam first, including examining your thyroid gland, heart, lungs, breasts, and abdomen. As part of the pelvic exam, your external genitalia will be examined for signs of infection or redness. Next, the doctor will slide a speculum into your vagina. The speculum allows the vagina to be opened slightly. This should not hurt or pinch, but may be uncomfortable. You also may feel a bit nervous or anxious. Try to take slow, deep breaths to help yourself relax.
At this point, the doctor will perform a
(see below for a description of this procedure). The doctor may also perform additional tests at this time to check for bacterial or viral infections, such as
You should not feel pain during the exam, but you may experience a pressure discomfort. If you are experiencing pain, tell your doctor. You may have a trace of vaginal bleeding afterwards from irritation of your cervix.
The doctor will insert a speculum into your vagina. The speculum allows the vagina to be opened slightly. The doctor will use a flat stick or a soft brush to collect a sample of cells from the outer cervix and its canal. These cells are placed on a slide or suspended in a solution and sent to a laboratory for evaluation. Your doctor should have the results of your Pap test in 1-3 weeks. If any abnormalities are found, your doctor will call you and discuss follow-up care.
Prior to your Pap test, it is important to keep in mind the following things:
- Do not schedule the Pap test during your menstrual period. If possible, schedule it two weeks after the first day of your period.
- Do not use vaginal creams, medications, or douches for 72 hours before the test.
- Do not use contraceptives, such as spermicidal foams, creams, or jellies, for 72 hours before the test.
- Do not have intercourse for 24 hours before the test.
Human Papillomavirus (HPV) Test
HPV is a very common
sexually transmitted disease
that can cause changes in cervical cells. In some cases, these changes can lead to cancer. The HPV test, which can be used along with the Pap test, screens women for the HPV virus. The same sample of cells taken for the Pap test can also be tested for HPV.
If you are aged 30 or older, you should have a Pap test along with a test to check for HPV every 5 years. Alternately, you may have the Pap test alone every three years.
When To Get Screened
If you are a healthy woman without prior cervical intraepithelial neoplasia 2 or worse, many professional health organizations offer these recommendations for screening:
- If you are aged 21-29 years—It is recommended that you have the Pap test every three years.
- If you are aged 30-65—It is recommended that you have the Pap test along with the HPV test every five years. (Or, you can continue to have just the Pap test every three years.)
- If you are aged 65 or older—You may be able to stop having Pap and HPV tests if you have had normal results (for example, three normal results in a row and no abnormal results in the past 10 years)
- If you have had a hysterectomy with removal of your cervix no screening is needed.
You will need to have Pap tests done more often if you have abnormal results or certain conditions, such as:
Talk to your doctor about the right screening schedule for you.
First cervical cancer screening delayed until age 21
less frequent Pap tests recommended. American College of Obstetricians and Gynecologists website. Available at:
http://www.acog.org. Published November 20, 2009. Accessed November 23, 2009.
HPV DNA testing and cervical cancer prevention. College of American Pathologists website. Available at:
http://www.cap.org/apps. Accessed March 20, 2012.
3/19/2012 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Screening for cervical cancer. US Preventive Services Task Force website. Available at:
http://www.uspreventiveservicestaskforce.org/uspstf/uspscerv.htm. Published March 2012. Accessed March 19, 2012.
Saslow D, Soloman D, Lawson H, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer.
CA: A Cancer Journal for Clinicians.
2012 Mar 14 early online.
3/17/2014 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Ronco G, Dillner J, et al. Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials. Lancet. 2014 Feb 8;383(9916):524-532.
7/7/2014 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Qaseem A, Humphrey LL, et al. Screening pelvic examination in adult women: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2014 Jul 1;161(1):67-72.