Cervical cancer
Most deaths from cancer of the cervix (the lower part of the uterus, or womb) could be avoided if women had regular checkups with Pap tests. This cancer can take several years to develop and most often is seen in women age 40 or older. Getting routinely screened can help you identify cervical cancer in its early stages, when it is highly curable. Screening even finds precancerous lesions so they can be removed before cancer ever starts to develop.
The most recent 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 3 years instead of each year, and many older women can stop having Pap tests altogether. Even if you do not need a Pap test each year, for most women, an annual pelvic exam is still recommended, reminds the American College of Obstetricians and Gynecologists.
Women who have not been tested for cervical cancer in 3 or more years or who have never been tested are especially urged to have a Pap test. The American Cancer Society, U.S. Preventive Services Task Force, and American College of Obstetricians and Gynecologists offer the following recommendations for women age 30 and older:
Women over age 30: As long as you have no new risk factors and have had normal results 3 years in a row, get retested every 2 to 3 years. At this age, you have the option of having a Pap test with an HPV DNA test. How often you should be tested depends in part on the test method—liquid or conventional. Also, if you have risk factors (such as exposure to DES in the uterus, previous diagnosis of cervical cancer, HIV, or a compromised immune system), you should be tested more frequently than every 3 years. Ask your health care provider for a recommendation on frequency.
Women over age 65 or 70: Get tested if you have not been tested in several years. Continue periodic screening if you risk factors, such as HIV or immune system disorders or a history of high-grade lesions or cervical cancer. Ask your health care provider about stopping testing if your last 3 tests were recent and showed no problems or if you have had a total hysterectomy (including removal of the cervix) because of cancer.
If you have had a hysterectomy, discuss the specifics of your case with a health care provider so you know whether continued screening is of value. In some cases, it is.
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Sources
American Cancer Society. Overview: cervical cancer: what causes cancer of the cervix? can it be prevented? Revised 2003 Nov 4. Available on the Internet at http://www.cancer.org. Accessed August 10, 2004.
American College of Obstetricians and Gynecologists. Cervical cancer screening: testing can start later and occur less often under new ACOG recommendations (press release). 2003 Jul 31. Available on the Internet at http://www.acog.org/from_home/publications/press_releases/nr07-31-03-1.cfm. Accessed July 15, 2004.
American College of Physicians. New pap guidelines reduce screening, but raise concerns about compliance. Observer. 2003 Apr. Available on the Internet at http://www.acponline.org/journals/news/apr03/pap_guides.htm?hp. Accessed July 15, 2004.
Smith RA, Cokkinides V, and Eyre HJ, for the American Cancer Society. American Cancer Society guidelines for the early detection of cancer, 2003. CA Caner J Clin. 2003;53:27-43. Available on the Internet at http://caonline.amcancersoc.org/cgi/content/full/53/1/27. Accessed August 5, 2004.
Centers for Disease Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, United States Department of Health and Human Services. Basic facts on screening and the Pap test. Available on the Internet at http://www.cdc.gov/cancer/nbccedp/cc_basic.htm. Accessed August 2, 2004.
Centers for Disease Prevention and Control, National Center for Chronic Disease Prevention and Health, United States Department of Health and Human Services. Cervical cancer and Pap test information. Available on the Internet at http://www.cdc.gov/cancer/nbccedp/info-cc.htm. Accessed July 15, 2004.
United States 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. Accessed July 15, 2004.
