"Courage is like a muscle. We strengthen it with use."~ Ruth Gordon
The Pap Smear, HPV: Screening & Preventing Cervical Cancer
Each year more than 10,000 women in the United States are diagnosed with invasive cervical cancer, and nearly 4,000 die of the disease. Most of these deaths could be prevented if all women received recommended screening.
A well-proven way to prevent cervix cancer is to have testing (screening) to find pre-cancers before they can turn into invasive cancer. The Pap test (or Pap smear) is the most common way to do this.
After age 21, In the U.S., sexually active young women are encouraged to see their gynecologist annually for routine preventive care, including a pap smear. Other countries do not routinely begin Pap screening until age 25. Fortunately, cervical cancer is very rare in very young women.
A pap smear, simply put, is a thin layer of cells gently obtained from your cervix, at the transformation zone - the area most vulnerable to HPV, therefore vulnerable to pre-cancerous changes of the cervix. The pap smear is just a screening test, however, an abnormal test does not mean you have cervical cancer or even pre-cancer, but that you need further evaluation.
By obtaining a pap smear annually between ages 21-30, you are reducing your risk of ever developing cervical cancer. In fact, because of this screening, originated by Dr. Papanicalau in the 1950s, cervical cancer as a cause of death decreased from #2 to #10.
In the US, over half of all invasive cervical cancers occur in women that have never had a Pap smear; an additional 10 to 20% of cancers occur in women that have not had a Pap smear in the preceding five years. About one-quarter of US cervical cancers were in women that had an abnormal Pap smear, but did not get appropriate follow-up (woman did not return for care, or clinician did not perform recommended tests or treatment).
Frequency of Testing
After the first test:
- Annually at first. Women should have a Pap smear annually until age 30 to check for cervical changes that could lead to cancer.
- If you are over age 30 or your Pap smears have been negative for 3 times in a row, you may only need a Pap smear every 3 years.
- Not monogamous: If you or your sexual partner have other new partners, then you should have a Pap smear every 2 years.
- After age 65-70, most women can stop having Pap smears as long as they have had three negative tests within the past 10 years.
- New sexual partner after age 65, you should begin having Pap smear screening again.
- After hysterectomy: If you have undergone a hysterectomy with removal of your cervix for non-cancerous conditions, you no longer need pap smears.
- More frequent screening is recommended for women with certain risk factors, including: being infected with human immunodeficiency virus (HIV), being immunosuppressed, having been exposed to diethylstilbestrol before birth, and having been treated for certain cervical abnormalities or cancer.
Making your Pap Tests More Accurate
You can do several things to make your Pap test as accurate as possible:
- Try not to schedule an appointment for a time during your menstrual period. The best time is at least 5 days after your menstrual period stops.
- Don't use tampons, birth-control foams, jellies or other vaginal creams for 2 to 3 days before the test.
- Don't douche for 2 to 3 days before the test, or ever.
- Don’t have sexual intercourse for 2 days before the test.
Take yourself out for a treat afterwards! You've earned it.
