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Treatment can completely stop the
cancer from forming. Most cervical
cancers begin in the cells
lining the outside por-
tion of the cervix—the
lower part of the uterus.
These cells do not
suddenly change into
cancer. Instead, the
normal cells of the
cervix first gradually
develop precancer-
ous changes, caused
by HPV, which then
turn into cancer.
What are Pap tests?
A Pap test is usually done as part of a pel-
vic exam. A doctor or other trained health-
care provider uses a tool called a speculum
to open the vagina. He or she uses a small
brush to collect a small sample of cells
from the cervix. That’s usually painless.
The cells are put on a slide or in liquid
and are sent to a lab to be examined.
Results are known within a week in most
cases.
In March 2012, the American Cancer
Society (ACS), the American Society
for Colposcopy and Cervical Pathology
and the American Society for Clinical
Pathology released new guidelines for the
prevention and early detection of cervical
cancer. The guidelines include a prefer-
ence for co-testing using the Pap test and
HPV test for women ages 30 to 65.
“Pap tests have been done yearly in
the past, but we now know that an-
nual screening is not needed and in fact
can lead to harm from treatment of cell
changes that would never go on to cause
cancer,” said Debbie Saslow, PhD, direc-
tor of breast and gynecologic cancer for
the American Cancer Society. “Since
1980, organizations
including the ACS
have recommended less
frequent screening. With
the addition of the HPV
test, we can test even less
frequently, as the risk of
precancer and cancer when
both tests are negative is
so low. With these recom-
mendations, our groups are
helping to make sure women
get the full lifesaving benefits of screening
while minimizing its known harms.”
Less than 1 percent of the women with
precancers of the cervix will develop
cancer. The change from cervical precan-
cer to cervical cancer usually takes several
years, but it can happen in less than a
year. For most women precancerous cells
will go away without any treatment. Still,
in some women precancers turn into true
(invasive) cancers. Treating all precancers
can prevent almost all true cancers.
Since the most common form of cervical
cancer starts with precancerous changes,
there are two ways to stop this disease
from developing. One way is to find and
treat precancers before they become true
cancers, and the other is to prevent the
precancers in the first place.
“The most effective way of preven-
tion is through safe sexual behavior and
through receiving vaccinations against the
most prevalent types of cancer that cause
HPV,” said Gentry.
WHO SHOULD
BE TESTED?
•
Women should not be screened
before age 21.
•
Women 21 to 29 should be
screened with the Pap test alone
(conventional or liquid-based) every
three years. HPV testing should not
be used for screening in this age
group.
•
For women 30 and over, the pre-
ferred approach is the Pap test plus
HPV testing (co-testing) every five
years. You can have just a Pap test
every three years if HPV testing isn’t
available. While screening with HPV
testing alone is promising, at this
time it is not recommended for most
clinical settings.
•
Women over age 65 should talk
with their doctors about whether
to continue being tested. If within
the last 10 years you’ve had three
consecutive normal Pap tests and no
abnormal ones or two consecutive
normal co-tests, you may be able to
stop being tested. Women in this age
group who have a history of precan-
cer (CIN2 or a more severe diagnosis)
should continue routine screening
for at least 20 years.
•
Women who have undergone a
hysterectomy (with removal of the
cervix) for reasons not related to
cervical cancer or precancer should
not be screened.
•
Women who have been vaccinated
against HPV should follow the age-
specific recommendations in these
guidelines (for unvaccinated women).
The new guidelines are not in-
tended for women with a history of
cervical cancer or exposure to diethyl-
stilbestrol (DES) in the womb or
women who are immunosuppressed
(e.g., HIV-positive). Costs and other
financial issues were not considered in
creating the guidelines.
women fromcervical cancer
tests
Y O U R W I N T E R
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