In 2022, the American Cancer Society estimated that 14,100 women in the U.S. would be diagnosed with cervical cancer – a malignant cancer that affects the cervix at the bottom of the uterus. Fortunately, 2 simple tests can detect precancerous cells in women so that you and your doctor can start treatments immediately.
We asked Dr. Sonata Cooper, an OB-GYN with Hackensack Meridian Pascack Valley Medical Group, to answer some of the most common questions about these tests.
What happens during the tests
Pap Test – also known as a Pap smear, a Pap test is the most used screening test for cervical cancer. The cervix is the bottom part of the uterus, where it meets the vagina. A doctor inserts a device in the vagina called a “speculum” which allows visualization of the cervix. Then, a small tool similar to a brush or spatula is used to lightly scrape cells from the cervix. The Pap test does not hurt, but can be a little uncomfortable for some.
HPV Test – HPV stands for human papillomavirus. This is a virus that causes cervical cancer and genital warts. HPV is transmitted by direct skin-to-skin contact, including sexual contact. It has been estimated that 75-90 % of sexually active adults will acquire at least one genital HPV infection before the age of 50. A majority of individuals have no signs or symptoms, and never develop any problems caused by HPV.
In the remaining 10 to 20 percent of females, however, HPV infection does not go away. In this situation, there is a greater chance of developing cervical pre-cancer and then cancer. For this reason, it’s important to get regular cervical cancer screening. HPV is co-tested based on your age or reflexively obtained if abnormal cells are seen from the pap.
Preparing for your Pap or HPV test
You do not need to do anything special to prepare. People sometimes hear that they shouldn’t have sex or put anything in their vagina for 2 days before a Pap test, but it turns out that is not necessary. Pap tests work fine even if you have had sex recently.
Your doctor may recommend scheduling your test when you do not expect to have your period, especially if you often have heavy bleeding.
When to get screened
Pap tests are completed based on age, history of abnormal pap smears, and those who have a normal immune system. The Centers for Disease Control recommends the following testing schedules based on the age of the woman being tested:
21-29 years old
You should start getting regular Pap tests at age 21. If your result is normal, you may be able to wait 3 years until your next one.
30-65 years old
Talk to your doctor to see which of the following options is right for you:
- Pap test only. If your result is normal, you may be able to wait 3 years until your next one.
- HPV test only. This is primary HPV testing. If your result is normal, you may be able to wait 5 years until your next one.
- HPV test and Pap test. This is co-testing. If both results are normal, you may be able to wait 5 years until your next one.
Older than 65
You may not have to get screened anymore if you:
- Have done regular testing and have had 3 normal Pap tests in a row
- Had your cervix removed as part of a total hysterectomy
Do I need to get screened if I had the HPV vaccine?
Yes. The current HPV vaccine (Gardasil-9) available in the U.S. does help prevent infection from 9 of the most clinically significant and high-risk strains of HPV. However, there are more than 100 different types of HPV, so even after being vaccinated, you should still get a screening test.
Results of the test
When your test results are known (which could take up to 3 weeks), your doctor will contact you if the results are abnormal. It is important to know that abnormal Pap tests are common and most people with an abnormal Pap test result do not have cancer.
If your Pap test has cells that look “abnormal,” your provider can do more tests to figure out what is causing the abnormality. They will decide what to do based on your age, what your Pap test shows and the results of any other tests you have had. Follow-up tests might include an HPV test, another pap test in a shorter interval of time or a biopsy of your cervix, known as a colposcopy.
If your test results are normal, your chances of getting cervical cancer in the next few years will be very low. Continue to go to your doctor for regular checkups, though you may not have a cervical cancer screening for many years.
Getting started
Cervical cancer affects more than 10,000 American females every year. If it turns out that you have cervical cancer or pre-cancer, there are effective treatments available. If your condition is found early, there is a good chance you can be cured.
If you are over 21 and have never had a Pap and/or HPV test, schedule one immediately. Follow your doctor’s advice for any treatment follow-up appointments.
For more information, visit our web page or call (201) 772-1600 to schedule your appointment.