House Call: Pap test important for cervical health
Women have become accustomed to Pap smears being a necessary part of adulthood. However, there has been confusion in recent years about when women should begin having this screening test, how often to have one and when to stop having them. Because January is Cervical Health Awareness Month, it is a good time to talk about the many different steps, including Pap smear, you can take to stay healthy and reduce your risk of cervical cancer.
A Pap smear is performed with a small brush that looks like a long mascara brush. Cells are brushed from the cervix (the opening of the uterus) and sent to a lab to determine if there are any precancerous or cancerous changes.
Precancerous changes in cervical cells are easily treated by destroying the abnormal cells with freezing or other methods. Advanced precancerous or early cancerous changes may require surgery. About 99 percent of cervical cancers have human papillomavirus (HPV) present in them. Some HPV types also cause genital warts and increase risk of rectal, esophageal and other cancers.
If you are younger than 26, consider getting vaccinated against HPV. The vaccine – which is most effective when given to girls and boys at age 11 – offers protection against the two strains of HPV (16 and 18) that are associated with 70 percent of all cervical cancers. There are two vaccines available; one is for men and women and the other is for women only. Talk with your health care provider about whether vaccination is appropriate for you.
Using a condom correctly and every time you have sex lowers your risk of HPV infection; however, a condom does not give complete protection against getting or transmitting HPV because HPV also infects areas not covered by a condom.
Because cervical cancer develops slowly, regular Pap tests are important. Early detection of precancerous cells and treatment makes all the difference, yet more than 12,000 women are diagnosed with cervical cancer each year in the United States. Fifty percent of them have never had a Pap test and 10 percent have not had one in 5 years.
The first Pap test is now recommended at age 21, and then every three years after that. The risk of getting cervical cancer for women screened every three years is extremely low.
Women younger than 21 do not need testing. Cervical cancer is very rare among this age group.
Most women 30-65 can continue with a Pap test every three years, or choose co-testing, which includes the Pap test and a second for the presence of HPV. Co-testing may be administered every five years if results are negative.
Women older than 65 who have had three consecutive negative Pap test results or two consecutive negative co-test results within 10 years may be able to discontinue cervical cancer screening.
More frequent testing may be recommended for women with higher risk factors such as a history of cervical cancer, HIV infection or immunosuppression.
Discuss with your health care provider how often you should be having Pap smears.
Follow-up testing from an abnormal Pap smear may include checking for active HPV, repeating the Pap, or doing a closer examination with biopsies (called a colposcopy). Depending on the test results, you may need more frequent Pap tests to monitor for further changes or require a procedure to remove abnormal cells.
It is nobody’s favorite visit to the doctor, but getting your Pap done could save your life and result in much less invasive treatments.
You can get more information on cervical health and cervical cancer from the National Cervical Cancer Coalition ( www.nccc-online.org, 800-685-5531).