Screening Tests for Adults (50 and Up)
Cervical cancer
Women who haven't been screened for cervical cancer in 3 years or more or who have never been tested are especially urged to have a Pap smear.
It is also recommended that women 30 years old or older be screened with an HPV DNA test in addition to a Pap smear. Persistent infections with certain types (strains) of HPV are now known to be the major risk factor for cervical cancer. Two types of HPV, types 16 and 18, account for about 70% of cervical cancers in the U.S.
- Women over 30 years old who have been sexually active, have no new risk factors, and have had normal results on both a Pap smear and an HPV DNA test for 3 years in a row should continue to be screened at least every 3 years with both tests.
- Many older women can stop having Pap smears altogether. Ask your health care provider what is right for you.
How often you should be tested depends on your risk factors such as exposure to DES in the uterus, previous diagnosis of cervical cancer, HIV, or a compromised immune system. If you have these risk factors, you should be tested more frequently than every 3 years. Ask your health care provider for a recommendation on frequency and if this test is still appropriate for you. If you have had a hysterectomy, discuss whether continued screening is of value. In some cases, it is.
Even if you do not need a Pap smear each year, for most women, an annual pelvic exam is still recommended, reminds the American College of Obstetricians and Gynecologists.
Links
To sign up for a personal Pap test scheduling reminder, click here.
Sources
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. 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 Physicians. New pap guidelines reduce screening, but raise concerns about compliance. Apr 2003. Observer. Available on the Internet at http://www.acponline.org/journals/news/apr03/pap_guides.htm?hp through http://www.acponline.org. Accessed 15 Jul 2004 and 18 Jan 2008.
American College of Obstetricians and Gynecologists. Human papillomaviruses and cancer: questions and answers. 8 Jun 2006. Available on the Internet through http://www.medem.com. Accessed 18 Jan 2008.
American College of Obstetricians and Gynecologists. Cervical cytology screening (practice bulletin 45). Aug 2003. Available on the Internet at http://www.guideline.gov. Accessed 8 Feb 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 through http://www.asccp.org. Accessed 17 Jan 2008.
American Academy of Family Physicians. Summary of recommendations for clinical preventive services (rev 6.4). 15 Aug 2007. Available on the Internet at http://www.guideline.gov. Accessed 4 Feb 2008.
American Cancer Society. American Cancer Society guidelines for the early detection of cancer. 28 Mar 2007. Available on the Internet at http://www.cancer.org/docroot/PED/content/PED_2_3X_ACS_Cancer_Detection_Guidelines_36.asp?sitearea=PED through http://www.cancer.org. Accessed 4 Feb 2008.
American Cancer Society. Overview: cervical cancer: What causes cancer of the cervix? Can it be prevented? Available on the Internet at http://www.cancer.org. Accessed 10 Aug 2004; 2006 revision accessed 8 Feb 2008.
American Society for Colposcopy and Cervical Pathology. Descriptions of new FDA-approved HPV DNA tests (clinical update). PDF available for download at http://www.asccp.org/pdfs/consensus/clinical_update_20090408.pdf through http://www.asccp.org. Accessed 11 Jun 2009.
National Cancer Institute. Human papillomaviruses and cancer: questions and answers (fact sheet). Available on the Internet at http://www.cancer.gov/cancertopics/factsheet/Risk/HPV through http://www.cancer.gov. Accessed 9 July 2009.
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/cgi/content/full/53/1/27 through http://caonline.amcancersoc.org. Accessed 5 Aug 2004 and 8 Feb 2008.
Solomon D, Papillo J, Davey D, on behalf of the Cytopathology Education and Technology Consortium. Statement on HPV DNA Test Utilization. Am J Clin Pathol 2009;131:768-769.
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 July 2004 and 8 Feb 2008.
US Preventive Services Task Force. Screening for cervical cancer: recommendations and rationale (AHRQ pub. 03-515A). Jan 2003. Available on the Internet at http://www.ahrq.gov/clinic/3rduspstf/cervcan/cervcanrr.htm through http://www.ahrq.gov. Accessed 8 Feb 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.
