Cervical Cancer: Screening
What is screening?
Getting screened for cervical cancer is one of the best ways you can take charge of your health. Screening tests can sometimes find certain cancers early when they’re small and before they’ve spread or caused symptoms. Cancer that’s found early is often easier to treat.
What screening tests are used for cervical cancer?
When you go for a cervical cancer screening, you can expect to have a few tests, including:
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Pap test. This test is also called a Pap smear. This test finds both cervical cancer and changes in cells of the cervix before they become cancer. These are called precancers.
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HPV test. This test is used to find signs of human papillomavirus (HPV) infection in the cells of the cervix. Certain types of HPV are linked to cervical cancer. Sometimes, the HPV test is done along with the Pap test. This is called a co-test. .
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Pelvic exam. This exam is often done along with Pap and HPV tests. It can help find some cancers of the uterus and other parts of the female reproductive system.
What happens during the screening?
For your cervical cancer screening, you lie on a table with your feet in stirrups and your knees apart and bent. The healthcare provider will place a device called a speculum into your vagina. You may feel pressure as the speculum goes in and slight discomfort if it’s cold.
The speculum holds your vagina open while your provider uses a small brush to scrape cells from your cervix. The cells that are removed are then sent to a lab. The test results may show that the cells are normal. Or the results may show inflammation, abnormal cells, precancer cells, or cancer cells. The HPV test is done on the cells, too. This shows whether you have an HPV infection.
During a pelvic exam, your healthcare provider will put their fingers into your vagina and press on your abdomen with the other hand. The provider is feeling for abnormal lumps (masses) or growths. You may feel a slight discomfort during the exam, but it only takes a few minutes.
When and how often should you get screened?
The American Cancer Society (ACS) recommends cervical cancer screening start at age 25. Some other expert groups, such as the American College of Obstetricians and Gynecologists (ACOG), have slightly different screening recommendations. Talk to your provider about the right screening schedule for you.
Women ages 25 to 65 should be screened with a primary HPV test every 5 years. But if a primary HPV test isn't available, the ACS says that screening can be done with either:
Women older than age 65 can stop screening if they've had regular screenings with normal results for the last 10 years and have no history of pre-cancer in the last 25 years.
At any age, women can stop screening if they had a total hysterectomy that included removing the uterus and cervix, unless it was done to treat cervical pre-cancer or cancer. People who have had a hysterectomy but still have their cervix should continue screening according to the guidelines.
Women who have been vaccinated against HPV should still follow the screening guidelines for their age group.
Some people may need more frequent tests
Women at high risk for cervical cancer may need to be screened more often. This includes women who have an HIV infection, a weak immune system, or were exposed to a medicine called DES before birth.
The ACS says women who have had a serious precancer should continue screening for at least 25 years after diagnosis, even if screenings go past age 65.
Talk with your healthcare provider about the schedule that is best for you.
No insurance? No problem
Even if you don’t have health insurance, you can still keep up with cancer screenings.
The National Breast and Cervical Cancer Early Detection Program is an option. It offers cervical cancer testing to women with no health insurance for free or at little cost. Each state runs its own program.
Contact your state or your county Department of Health to find a program near you. Other private or volunteer clinics in your area may also provide screenings for free or at a much-reduced cost.