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Early on, problems in the cervix produce no symptoms. Often, the only way to know about cervical changes is to do a Pap test. A Pap test can find cervical problems early, when they are easier to treat. Pap tests can also detect some infections of the cervix and vagina.
A Pap test is a procedure that helps find changes in the cervix that may lead to cancer. (The cervix is the part of the uterus that opens into the vagina.) For this test, a small sample of cells is taken from the cervix. This is done in your health care provider’s office. The cells are then analyzed in a lab. A Pap test is a safe procedure. It takes just a few minutes and causes little or no discomfort.
HPV (human papillomavirus) is a family of viruses that spread through skin contact. Certain types are almost always spread through sexual contact. Some HPV types cause genital warts (condyloma). But not all types of HPV cause visible symptoms. Certain types cause cell changes (dysplasia) in the cervix that can lead to cancer. In fact, HPV infection is the most important risk factor for cervical cancer. Doctors can now test for HPV. Testing for HPV is often done with the Pap test. This is called co-testing. That’s why it’s important to have Pap tests as recommended by your health care provider. This helps ensure that any abnormal cells will be found and treated before they become cancerous.
Ask your health care provider when to start having Pap tests, whether you should have an HPV test done at the same time, and how often to have them. Follow these guidelines from the American Cancer Society for cervical cancer screening:
A first Pap test at age 21. And then every 3 years until age 29, HPV testing is not recommended during this time, though it may be done to follow-up on an abnormal Pap test.
Starting at age 30, the preferred testing is a Pap test done with an HPV test every 5 years. This co-testing should be done until age 65. Another option for women in this 30-65 age group is to have just the Pap test done every 3 years.
You may need a different screening schedule if you are at high risk for cervical cancer. Risk factors include having HIV, immune suppression, or exposure to the medication DES while your mother was pregnant with you. Talk with your doctor about the best schedule for you.
If you’re over 65 and have had regular screenings for the last 10 years with no abnormal results in the last 20 years, you may stop cervical cancer screening.
If you had a hysterectomy that included removing your cervix, you can stop screening unless the hysterectomy was done to treat cervical cancer or pre-cancer. If you still have your cervix after the hysterectomy, you should continue screening according to the above guidelines.
No woman of any age needs to be tested each year.
Women who have been vaccinated for HPV should still follow these guidelines.
If you have had cervical cancer, talk to your doctor about the screening plan that's best for you.