Most deaths from
cancer of the cervix (the lower part of the uterus, or womb) can be avoided by having regular checkups and
Pap smears. This cancer can take several years to develop. Most often, cancerous cells are seen in women 40 years of age or older. Getting routinely screened can help you identify cervical cancer when it is highly curable. Screening can also find precancerous lesions that can be monitored or removed before cancer ever starts to develop.
Girls should see a gynecologist for the first time between 13 and 15 years of age. This visit, which may not include a Pap smear or pelvic exam, is strongly recommended by the American College of Obstetricians and Gynecologists (ACOG) so that appropriate guidance, screening, and preventive health measures can be addressed.
The American Cancer Society, U.S. Preventive Services Task Force, and ACOG recommend the following for teen girls and young women:
- Begin testing about 3 years after her first vaginal intercourse, but no later than 21 years of age. Then, get a Pap smear each year until age 30.
Pap smears are available from family planning clinics and public health departments as well as from health care providers (including pediatricians, family physicians, obstetrician-gynecologists, and nurse practitioners).
Teen risk
Experts say that the following increases a teen girl’s risk of cervical cancer:
- If she has sex with more than one partner or a partner who has had sex with another person
- If she or a partner has genital warts
- If she has human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS)
- If she smokes
Under these conditions, the cells of the cervix are more likely to change in ways that lead to cancer.
What’s right at your age
Guidelines on cervical cancer screening lengthen the interval between tests for many women once they have had 2 or 3 normal Pap smears in a row. Younger women are monitored closely for high-risk types of disease, middle-aged women are more likely to be told to get retested in 2 to 3 years instead of each year, and many older women can stop cervical cancer screening altogether.
An HPV test may be a helpful addition to the Pap test for general screening of women 30 years of age and older and for those whose Pap test shows slightly abnormal cell changes.
Even if you do not need a Pap test each year, for most women, an annual gynecologic and pelvic exam is still recommended, reminds the ACOG.
Links
American College of Obstetricians and Gynecologists: "Tool kit for teen care: pap tests" available at http://www.medem.com.
To sign up for a personal Pap test scheduling reminder, click here.
Sources
American Cancer Society. Overview: cervical cancer: What causes cancer
of the cervix? Can it be prevented? Revised 4 Nov 2003. Available on
the Internet at http://www.cancer.org. Accessed 10 Aug 2004; 2006 revision accessed 8 Feb 2008.
American Cancer Society. DES Exposure: Questions and Answers. Available online at http://www.cancer.org/docroot/CRI/content/CRI_2_6x_DES_Exposure_Questions_and_Answers.asp through http://www.cancer.org. Accessed September 2008.
American College of Obstetricians and Gynecologists. Human papillomaviruses and cancer: questions and answers. 8 Jun 2006. Available on the Internet at http://www.medem.com. Accessed 18 Jan 2008.
American College of Obstetricians and Gynecologists. Tool kit for teen care: pap tests. 2003. Available on the Internet at http://www.medem.com. Accessed 17 Jan 2008.
American College of Obstetricians and Gynecologists. ACOG clarifies recommendations on cervical cancer screening in adolescents (news release). 30 Sep 2004. Available on the Internet at http://www.acog.org/from_home/publications/press_releases/nr09-30-04-1.cfm through http://www.acog.org. Accessed 2004 and 18 Jan 2008.
American College of Obstetricians and Gynecologists. Cervical cancer
screening: testing can start later and occur less often under new ACOG
recommendations (press release). 31 Jul 2003. Available on the Internet
at http://www.acog.org/from_home/publications/press_releases/nr07-31-03-1.cfm through http://www.acog.org. Accessed 15 Jul 2004 and 18 Jan 2008.
American College of Obstetricians and Gynecologists. First ob-gyn visit
recommended in early teens (news from ACOG). 10 May 2006. Available on
the Internet at http://www.medem.com. Accessed 17 Jan 2008.
American College of Physicians. New pap guidelines reduce screening, but raise concerns about compliance. Apr 2003. Observer. Available on the Internet at http://www.acponline.org. Accessed 15 Jul 2004 and 18 Jan 2008.
American Society for Colposcopy and Cervical Pathology. What women
should know about HPV and cervical health. 2003. Available on the
Internet at
http://www.asccp.org/patient_edu.shtml. Accessed 17 Jan 2008.
Smith RA, Cokkinides V and Eyre HJ, for the American Cancer Society.
American Cancer Society guidelines for the early detection of cancer,
2003. CA Cancer J Clin 53:27-43. Available on the Internet at http://caonline.amcancersoc.org. Accessed 5 Aug 2004 and 18 Jan 2008.
US Centers for Disease Control and Prevention. Basic facts on screening and the Pap test. Oct 2003. PDF available for download at http://www.cdc.gov/cancer/cervical/pdf/cc_basic.pdf through http://www.cdc.gov. Accessed 2 Aug 2004 and 18 Jan 2008.
US Preventive Services Task Force. Screening for cervical cancer. Release date Jan 2003. Available on the Internet at http://www.ahcpr.gov/clinic/uspstf/uspscerv.htm through http://www.ahcpr.gov. Accessed 15 Jul 2004 and 18 Jan 2008.
US Food and Drug Administration. Cervical Cancer Screening. FDA Consumer Magazine. January-February 2004. Available online at http://www.fda.gov/Fdac/features/2004/104_cancer.html through http://www.fda.gov. Accessed September 2008.
