Cervical Cancer Screening: What You Need to Know

Cervical cancer is a cancer of the cervix, the part that connects the vagina to the uterus. Although it is most commonly found in people ages 35–60, anyone can get cervical cancer. One of the main causes for cervical cancer is long-term infection with certain types of human papillomavirus (HPV). 

“The best way to prevent cervical cancer is through HPV vaccination, especially for young children and preteens. Talk to your child’s doctor or your gynecologist about this potentially cancer-preventing vaccine,” says Ami Vaidya, M.D., gynecologic surgical oncologist at Hackensack University Medical Center. “In addition, regular screenings can help to get ahead of a cervical cancer diagnosis. Most cases that are found early respond to treatment effectively and therefore allow you to lead a longer and healthier life.”

What types of cervical cancer screenings are there?

The goal of cervical cancer screenings is to find precancerous changes in your cervical cells. When found, treatment can be used to prevent cervical cancer from developing altogether. 

“Early screening and detection is good for any cancer, particularly in the case of cervical cancer, as the high-grade precancerous cells when detected are easier to treat and need minor surgery,” says Neeti Misra, M.D., obstetrician/gynecologist at Old Bridge Medical Center and Raritan Bay Medical Center. “Not all precancerous cells need surgical treatment and can be followed up with regular Pap smear screening to check for progression of the disease, which most of the time can be anywhere between 5 and 15 years. It is dependent on the age of the patient, the kind of HPV infection and the pathology grade of the lesion.”

There are two main types of cervical cancer screenings that can help you get diagnosed early and lead to better treatment outcomes: 

• HPV test: checks for infection with high-risk HPV types that are associated with causing cervical cancer
• The HPV virus can cause changes in the cervix that can lead to cancer
• Pap smear: also known as a Pap test, used to check cervical cells for changes caused by HPV that can lead to the development of cervical cancer is left untreated
• Can find precancerous cells as well as cervical cancer cells
• Also can be helpful in discovering non-cancerous conditions such as infections or inflammation

When should I get screened?

The frequency of your screenings can depend on many factors, including your age and health history. There are certain recommendations for each age group for when to get screened: 

• 21 to 29 years old: you should get your first Pap smear at age 21, if your results are normal, your doctor may recommend to wait three years before your next Pap smear
• Even if you are sexually active, you do not need a Pap smear before age 21
• For this age group, it is normal to get tested approximately every three years
• 30 to 65 years old: talk to your health care provider to determine which method of testing is best for you, there are multiple recommended methods for this age group
• HPV test every five years
• HPV/Pap smear co-test every five years
• Pap smear every three years
• 65 years old and above: discuss your options with your doctor and see if cervical cancer screenings are still necessary for you
• For those who have screened regularly and gotten normal test results, your doctor may tell you that you no longer need to attend regular screenings
• If you have not been screened regularly or you have received abnormal test results, your doctor may recommend for you to continue screening

“Many women may recall having a Pap smear done every year, however, research has shown that extended interval screening that includes testing for HPV DNA or RNA is as effective or even more effective than doing an annual Pap test alone,” says Mark Borowsky, M.D., gynecologic oncologist at Jersey Shore University Medical Center. “Since cervical cancer typically takes years to develop and nearly always involves long-term infection with high-risk strains of HPV, cervical cancer screening is now initiated at age 21 instead of 18 and the screening interval can be safely increased as long as highly sensitive HPV testing is a part of the screening.”

How do these tests work?

Both the HPV test and the Pap smear can be conducted in a doctor’s office or clinic, often during a pelvic exam. They can be done at the same time (known as a co-test), or alone depending on your doctor’s recommendations, availability or preference. Each test is effective in finding cancer and pre-cancer.

The most important thing to remember about cervical cancer testing is that you should be getting screened regularly no matter which test you get.

What should I expect during my screening?

• You will have to lie down on the examination table so that your doctor can conduct the Pap smear and/or HPV test. 
• Once laying down, you will need to bend your knees and put your feet into the support system that will be located at the end of the table. 
• Your doctor will use a tool called a speculum in order to open up the vagina to examine your cervix. 
• A small brush or spatula will be used to collect the sample cells necessary to conduct the testing. 
• This whole process typically only takes a few minutes. 

Once collected, the sample will be sent to a lab where lab specialists will see if your cells are infected with any of the types of HPV that can cause cervical cancer. At the lab, your cells can also be checked for any abnormalities by a Pap smear. If the lab does both tests at the same time, this is an example of the co-test. 

Your doctor will communicate with you every step of the way to let you know what they are checking and what to expect. 

Next Steps & Resources:

• Our source: Mark Borowsky, M.D.,Ami Vaidya, M.D., and Neeti Misra, M.D.
• To make an appointment with near you, call 800-822-8905 or visit our website.
• Learn more about our gynecologic cancer services.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.