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Cervical Cancer Screening

Cervical cancer screening is used to find changes in the cells of the cervix that could lead to cancer. It usually takes three to seven years for high-grade changes in cervical cells to become cancer. Cervical cancer screening may detect these changes before they become cancer. Women with low-grade changes can be tested more frequently to see if their cells go back to normal. Women with high-grade changes can get treatment to have the cells removed.

Cervical cancer screening includes the Pap test and, for some women, an HPV test. Both tests use cells taken from the cervix. The screening process is simple and fast. You lie on an exam table and a speculum is used to open the vagina. Cells are removed from the cervix with a brush or other sampling instrument, put into a special liquid and sent to a laboratory for testing.

Women aged 21–29 years should have a Pap test alone every three years. HPV testing is not recommended. Women aged 30–65 years should have a Pap test and an HPV test (co-testing) every five years. It also is acceptable to have a Pap test alone every three years.

You can stop having cervical cancer screening after age 65 years if:

  • you do not have a history of moderate or severe abnormal cervical cells or cervical cancer, and
  • you have had either three negative Pap test results in a row or two negative co-test results in a row within the past 10 years, with the most recent test performed within the past five years.

Women who have a history of cervical cancer, are infected with human immunodeficiency virus (HIV), have a weakened immune system, or who were exposed to diethylstilbestrol (DES) before birth may require more frequent screening and should not follow these routine guidelines.

Women who have been vaccinated against HPV still need to follow the screening recommendations for their age group.

Getting Abnormal Results

Many women have abnormal cervical cancer screening results. An abnormal result does not mean that you have cancer. Remember that cervical cell changes often go back to normal on their own. And if they do not, it often takes several years for even high-grade changes to become cancer.

If you have an abnormal result, additional testing is needed to find out whether high-grade changes or cancer actually are present. Sometimes, only repeat testing is needed. In other cases, colposcopy and cervical biopsy may be recommended. If results of follow-up tests indicate high-grade changes, you may need treatment to remove the abnormal cells. You will need follow-up testing after treatment and will need to get regular cervical cancer screening after the follow-up is complete.

Source: American College of Obstetricians and Gynecologists.