What You Need to Know About Cervical Cancer Screening

Cervical cancer is the fourth most common cancer among women, with more than 600,000 new cases a year worldwide. You can protect yourself from this disease by getting screened regularly. January is Cervical Health Awareness Month, a good time to learn more about testing to prevent cervical cancer.

Cervical Cancer Symptoms

Cervical cancer begins as a growth of cells in the cervix — the lower, narrow end of the uterus that connects to the vagina. Cervical cancer may not cause any symptoms at first. As the cancer grows, symptoms may include:

• Abnormal vaginal bleeding, such as after sex or between periods
• Unusual discharge from the vagina
• Pain during sex
• Pelvic pain
• Problems with urination or bowel movements
• Blood in urine  

If you have any of these symptoms, you should see your healthcare provider right away. But don’t wait for symptoms to appear to take action. If you have a cervix, you should get screened for cervical cancer regularly. This includes getting a Pap test and/or an HPV test.

What is a Pap Test?

A Pap test (also called a Pap smear) is used to look for precancerous cells in the cervix — a sign that cervical cancer may be developing. The Pap test is often combined with a test for human papillomavirus (HPV), a virus that is passed from person to person through sexual activity. HPV can cause changes in cervix cells that may lead to cervical cancer.

The Pap test is done in a clinic or doctor's office. The patient lies on an exam table with their feet in stirrups. A clinician inserts a medical device called a speculum into the vagina to hold its walls apart. This may cause a brief feeling of cramping or pressure. The clinician then uses a brush to collect cells from the cervix. The cells are sent to a lab to be examined under a microscope to see if they are abnormal.

What is an HPV Test?

The HPV test detects the presence of certain “high risk” types of HPV in the cervix. The HPV test is often used for cervical cancer screening because more than 90 percent of cervical cancer cases are caused by HPV. The HPV test by itself cannot find precancerous or cancerous cells. However, if the result of the HPV test is positive, additional testing can be done to look for abnormal cells.

HPV tests can find the virus before it causes cell changes, while the Pap test identifies cell changes after they’ve happened. For that reason, some healthcare professionals recommend HPV testing as the primary cervical cancer screening.

How Often Should You Be Tested?

The recommended frequency of cervical cancer screening depends on your age and risk factors. You should talk with your healthcare provider to determine the testing schedule that is right for you.

For people between the ages of 21 and 29, Pap tests are recommended every three years. The American Cancer Society recommends that people with a cervix start HPV testing at age 25.

For people between the ages of 30 and 65, there are three options:

• A Pap test by itself every three years
• An HPV test by itself every five years
• A combined Pap test and HPV test every five years

More frequent Pap tests may be needed if you have certain risk factors, including:

• History of cervical cancer
• Previous Pap test that showed precancerous cells
• HIV infection
• Weakened immune system
• Exposure to DES (diethylstilbestrol) before birth

After age 65, cervical cancer screenings can stop:

• If you’ve never had abnormal cervical cancer cells or cervical cancer, and
• You’ve had two or three negative tests in a row (depending on the type of test)

You may be able to stop cervical cancer screening if you’ve had a total hysterectomy (complete removal of the uterus and cervix) that was done for reasons other than cancer. It’s important to talk to your healthcare provider about your health history and risk factors before making a decision about stopping cervical cancer screenings.

Are At-Home Tests Coming?

Pap testing requires a trip to a clinic or doctor’s office. However, there is an effort underway to make HPV testing easier to do, in the hopes that more people will get screened. You may eventually be able to do it at home.

The U.S. Food and Drug Administration (FDA) recently approved two self-collection HPV tests. With these new tests, a person can collect their own vaginal samples. The FDA requires that self-collection be done in a healthcare setting, such as a doctor’s office, a pharmacy, or a mobile clinic, so that a healthcare professional is available to answer questions and provide guidance. The patient is given a sample collection kit, instructions, and a private space to do the self-collection. The sample is then sent to a lab for testing.

Clinical trials are underway to determine if self-collection at home is as effective as sample collection in a health care setting. The National Cancer Institute is leading the research and will submit its data to the FDA, in hopes of expanding self-collection to home settings.

At-home HPV testing is already available in other countries, including Canada. At-home HPV test kits can be purchased on the Internet, but they are not FDA approved. Experts at the MD Anderson Cancer Center say at-home tests are not proven to be accurate and they do not recommend at-home HPV testing at this time.

Schedule Your Test Now

If you are eligible for cervical cancer screening, we hope you’ll contact your healthcare provider and make an appointment to be screened. It’s an important way to stay healthy and prevent cervical cancer.

Cervical cancer screening is just one of the recommended preventive screenings for adults. To learn more, check out our blog article on 12 preventive screenings to help you stay healthy.