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Notes on Women's Health
Notes on Women's Health

How Often Should I Receive Cervical Cancer Screening?

Cervical cancer screening - how often do you need to go?Every year, nearly 13,000 women in the U.S. are diagnosed with cervical cancer. One of the most effective ways for reducing your chances of developing cervical cancer is to receive the human papillomavirus (HPV) vaccine. This vaccine can help prevent the vast majority of cervical cancer cases.

Early detection can improve the chances of successful treatment. The best way to detect cervical cancer early is through regular screening with a Pap test. By monitoring for abnormal cells in your cervix, your OB-GYN can identify cancerous or precancerous conditions before they progress. Early detection means treatment for cervical cancer can begin sooner, leading to higher survival rates. The primary surveillance methods for cervical cancer are pelvic examinations that include Pap smears.

What is a Pelvic Examination with a Pap Smear?

During a “pelvic examination,” your OB-GYN examines your inner and outer genitalia and reproductive organs. They check for general health and signs of many conditions, including sexually-transmitted infections, pelvic organ prolapse, and cervical cancer. During a pelvic exam, your OB-GYN may remove cervical cells using a gentle brushing technique. The specimen is then examined in a laboratory to check for abnormal cells. This procedure is called a Pap smear.

When Should I First Have a Pelvic Exam and Pap Smear?

For most women, this answer is at 21 years old, according to the American College of Obstetricians and Gynecologists (ACOG) as well as the Centers for Disease Control and Prevention (CDC). However, there are conditions that may necessitate testing women before age 21. These conditions include women with HIV infections, prior cervical cancer patients, and women with weakened immune systems. Your OB-GYN will let you know if you fall into this category.

Once you have your first pelvic exam, you will need another exam every three years until the age of 29, assuming all your testing is negative. Once you turn 30, you will likely be able to have a pelvic exam and Pap smear every five years. However, beginning at age 30, you will also likely need to also receive HPV testing, which can be performed at the same time as your pelvic exam and Pap smear.

Why Do I Need HPV Testing?

Researchers have found an extremely strong link between HPV infections and cervical cancer. In fact, upward of 90% of all cervical cancer cases are associated with an HPV infection. There are numerous strains of HPV. However, about 13 strains are thought to be high-risk for cervical cancer. Testing for these HPV strains will let your OB-GYN know if more frequent monitoring is needed or further, more invasive tests – like a colposcopy (examination of your cervix with a scope) or cervical biopsy – are warranted. It is important to note that you still need HPV testing even if you received the HPV vaccine. 

Should I Stop Testing for Cervical Cancer?

Most women no longer need pelvic examinations for cervical cancer, Pap smears, or HPV testing past the age of 65, as long as their recent results have all been normal. You may be able to stop testing at a younger age, especially if you have had your cervix surgically removed for a non-cancerous condition. For a definitive answer, ask your OB-GYN.

However, most women who have undergone a hysterectomy without cervix removal still need testing up to age 65. During some types of hysterectomies, only the uterus is removed, not the cervix. So, these women will still require standard testing for cervical cancer.

Do Abnormal Results Mean I Have Cervical Cancer?

Not necessarily. An abnormal Pap smear means that the laboratory detected abnormal cells. This is not a definitive cancer diagnosis. The smear may need to be repeated, or you may need different diagnostic testing.

A positive HPV test also does not necessarily indicate cancer. However, a positive test is likely a reason for more diligent and frequent monitoring.

Unlike other types of cancer, cervical cancer is that it is generally slow to progress than other cancer types. Most cases take anywhere from three to seven years to become advanced. This slow progression means that regular examinations and testing are of the utmost importance so that treatment can begin before the cancer spreads. 

Take time this January and every month to be mindful of cervical cancer risks, and do not neglect your pelvic examinations. You can schedule an appointment with Dr. John Garofalo, OB-GYN, by clicking here.

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