For most women, the lifelong routine of cervical cancer screening begins around age 20 with a first Pap smear. It used to be routine for these exams to occur every year, but now that we know more about human papilloma virus (HPV), women can delay these exams for anywhere from 3-5 years under certain conditions. Women need to make sure they understand what those conditions are and whether or not they meet them: if you’re not sure where you stand, read on.
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What is a Pap Smear?
Pap is short for Papanikolau, the last name of the Greek doctor who invented the test in the mid-1940s. He discovered that pre-cancerous or cancerous cells collected from a woman’s cervix looked different than the healthy ones under a microscope. Today, we’ve been able to improve on this foundation with more research. We now know that if someone is negative for HPV, the odds of their developing cervical cancer are slim (though not entirely impossible).
What is HPV?
Human papilloma virus (HPV) is an extremely common virus that is transmitted sexually. Some doctors think that HPV might be as common as the cold. There are over 150 types of HPV. Some cause no symptoms, or only cause warts on the genitals, but others are known to cause cervical cancer. The virus causes cancer by mutating cells in the cervix which later become cancerous. Luckily, knowing you have HPV means your doctor can use the Pap to its best ability. If you test positive for HPV, your doctor should always perform additional tests–at least another HPV test and Pap smear–within the next year. Most HPV is killed off by the immune system within a year or two, and though there is no treatment for the virus itself, warts and both pre-cancerous and cancerous cells can be treated once they’re discovered.
Because we know how closely linked HPV is to cervical cancer, today’s doctors are usually comfortable allowing a woman who is negative for HPV to go several years without a Pap smear. Women under the age of 30 are still recommended to get the test every three years, while women over 30 can go as long as 5 years provided their results have been normal. However, that can change based on many factors, like family history or even the woman’s sex life. Still, your doctor should be giving you a Pap smear every 3-5 years, even if your sexual partner hasn’t changed—and even if you’ve been vaccinated for HPV, since it is still possible to get cervical cancer even if you don’t have HPV.
When to Go?
Women should know they can’t have a Pap smear taken during their monthly menstrual cycle. The best time to go is 14 days after your period started, somewhere near the middle of your cycle. Even after menopause, women need to be screened for cervical cancer until at least age 65, maybe for their whole lives if they have a family history, unless they’ve had a full hysterectomy.
What Happens Next?
It’s important to keep up with regular Pap exams because the test isn’t always 100% accurate. Only repeated testing can ensure the results are really accurate. This is why if you have an abnormal result, your doctor’s first step might be to wait a week or two and test again. Especially for women in their 20s, abnormal Pap results are common enough to not cause immediate alarm. However, in some cases doctors will want to get a closer look, usually through a procedure called colposcopy that lets them get more information about the troublesome cells.
It’s important for women to remember that when it comes to issues like cervical cancer screening, they’re in charge of their own destinies. If you want to be screened more frequently than your doctor recommends, make sure you’ve discussed all these factors with them and understand their reasoning. Even those in the most stable sexual relationships who are vaccinated for HPV can still be at risk, and the small inconvenience of conducting the routine test far outweighs some of the alternative possibilities.