Did you know that the incidence of cervical cancer has dropped more than half over the last thirty years? It has gone from being the number one cause of cancer deaths among women, to number fourteen since the 1950s. Do you know why? Because of cervical cancer screening, better known as a “pap” (short for papanicolaou). Due to this, it has become one of the most preventable cancers. This screening has been so life saving because the early cell changes and early stage cancers in the cervix often have no symptoms, and they may not present themselves until a much later stage, when treatment is more difficult.
What causes cervical cancer? Human Papilloma Virus (HPV) has been found to be present in over 99% of cervical cancer cases, and is believed to be the number one causative factor in its development. HPV is a sexually transmitted disease contracted through genital-to-genital contact. By age 50, 80% of women have some type of HPV, and there are over 100 types (over 90% of infections resolve spontaneously within 2 years). However, only a handful of strains are linked to cervical cancer, and just two of them account for over 90% of all cases (these are considered “high-risk” types, numbered 16 and 18).
Who needs to be screened and when? Our doctors follow the ASCCP (American Society for Colposcopy and Cervical Pathology) guidelines for cervical cancer screening.
• Under 21: No Screening Necessary
• Ages 21-29: Regular Pap Test Every 3 Years (No HPV testing)
• Ages 30-65: Pap Test with HPV co-testing Every 3 years
• Ages 65 and Up: No Screening Necessary (with no history of abnormal pap in the previous 20 years)
*These are all guidelines and your doctor may recommend a different screening schedule based on your personal and family history.
What about those who have had the HPV vaccine? Currently, the ASCCP recommends the same screening guidelines as for those women who have not been vaccinated.
Does the vaccine prevent cervical cancer? No. While it does protect against several high-risk strains of HPV, it does not cover all of them, and therefore does not prevent all cervical cancers.
Of course, when someone has a pap that comes back abnormal, it can be upsetting, but it does not necessarily mean that they have cancer or will get cancer. The pap is a preliminary test, and when it is abnormal, additional screening to obtain a definitive diagnosis is performed.
Regardless of age, any woman who is sexually active should see a gynecologist for a well woman exam once a year. January is the perfect time to make sure you know when you are due for your exam, and mark it on your calendar!