Cervical Cancer & Pap Smears

Cervical Cancer Prevention and Early Detection

What is cervical cancer?

Cervical cancer starts in cells lining the cervix. The cervix is the lower part of the uterus (womb)

Cervical cancer screening tests can find cervical cancer and precancer in the early stages when it can be treated.

CERVICAL CANCER RISK FACTORS

The most important risk factor for cervical cancer is infection with the human papillomavirus (HPV). There are over 100 different types of HPV; however, most types of HPV do not cause cancer. At least 80 percent of women are exposed to the HPV virus during their lifetime. Most of the time, the body’s immune system gets rid of the virus before it does harm.

  • Low risk types — HPV types 6 and 11 can cause genital warts and are low-risk types because they rarely cause cervical cancer
  • High risk types — HPV types 16 and 18 are considered high-risk types because they may cause cervical cancer in some women.

HPV is spread by direct skin-to-skin contact, including sexual intercourse or any other contact involving the genital area (eg, hand to genital contact). It is not possible to become infected with HPV by touching an object, such as a toilet seat. Most people who are infected with HPV have no signs or symptoms. Most HPV infections are temporary and resolve within two years. When the virus persists (in 10 to 20 percent of cases), there is a chance of developing cervical precancer or cancer. However, it usually takes many years for HPV infection to cause cervical cancer.

Smoking can increase the risk of cervical cancer up to fourfold, as does having a condition or taking a medicine that weakens the immune system.

A vaccine is available to help prevent infection with some types of HPV (types 6, 11, 16, and 18) and is recommended for girls or women between the ages of 9 and 26 years and for boys or men between the ages of 9 and 21 years, but can be given up to 26 years of age. Smoking cessation is recommended for those who smoke

CERVICAL CANCER SCREENING TESTS

There are several ways to screen for cervical cancer. The traditional screening test is called a Pap smear.

Pap smear — The Pap smear is a method of examining cells from the cervix. To perform a Pap test, a doctor or other health care provider will perform a pelvic exam and use a small brush or spatula to collect cells from the cervix. The cells are smeared on a glass slide (called a traditional Pap smear) or added to a preservative fluid (called liquid-based, thin layer testing).

HPV testing — An HPV test can be done along with a Pap test or as a separate test. Like a Pap test, the HPV test is done during a pelvic exam, using a small brush to collect a sample from the cervix. HPV tests do not test for all different types of HPV. They test for the strains of HPV that are the highest risk to cause cervical cancer.

WHO SHOULD BE SCREENED FOR CERVICAL CANCER?

Younger women — it is recommended that cervical cancer screening start at age 21

Older women — Most experts feel that women who are 65 years or older can stop having cervical cancer screening if:

  • You have had screening tests on a regular basis in the past
  • You have had at least three normal Pap tests in a row or two tests with combination Pap and HPV test over the past 10 years, with the most recent within the past five years

After hysterectomy — Women who have had a total hysterectomy (your uterus and cervix were removed) do not need a Pap test

SCREENING FREQUENCY

Depending on your age and how you are screened, screening is recommended every three or five years for most women over age 21. Most woman have pap tests at their 6 weeks check up after delivery.

More frequent testing may be needed if test results are not normal, or for women with HIV disease or other specific immune system conditions.

PREPARING FOR YOUR CERVICAL CANCER SCREENING

A Pap test or HPV testing can be done at any time during your menstrual cycle. Some doctors recommend waiting until your menstrual cycle has ended before doing a Pap test.

RESULTS

Pap test — If a Pap test was done as part of your cervical cancer screening, the results from your Pap test will be available about a week after your visit. Pap test results may be reported as:

  • Negative – Pap tests that have no abnormal, precancerous, or cancerous cells . ●Abnormal results – Cervical cells may appear abnormal for a variety of reasons. For example, you may have a cervical infection, or you may have a precancerous area or even cervical cancer.

HPV test — If a HPV test was done as part of your cervical cancer screening, the results will be available a few weeks after your visit. The results may be reported as:

  • Negative – There are no high-risk HPV strains present.
  • Positive – There are high-risk HPV strains present.

Follow-up testing — If your Pap or HPV test is abnormal, you may need follow-up testing; the best strategy depends on several individual factors.

Please discuss your individual Pap smear screening schedule with us.

Adapted from www.uptodate.com