Issue
Cervical cancer screening
Ryan McKey/ Digital Version/ Thinkstock

As recently as the 1940s, cervical cancer was a major cause of death among women in this country. That changed when Dr. George Papanicolaou developed the Pap smear, or Pap test, that enables doctors to detect suspicious cells in the cervix before they became cancerous. It can also diagnose cancer in an early stage when treatment is more successful. The cervix is the lower end of the uterus.

The development of the Pap smear had a significant impact. According to a report by the National Institutes of Health, between 1955 and 1991, the incidence and death rates attributed to cervical cancer declined by more than 60 percent, making it now the 14th most common cancer in women. The American Cancer Society (ACS) estimates that 12,340 women will be diagnosed with cervical cancer in 2013 and 4,030 will succumb to the disease.

During the test the provider takes samples of the cells of the cervix using a soft brush or a flat scraping device. The samples are viewed under a microscope for suspicious changes. A positive result, which means that abnormal or unusual cells were discovered, does not necessarily indicate cancer. Several infections can cause temporary changes. However, if the abnormalities persist over a period of time, additional testing is required.

A test for HPV, which is responsible for virtually all cases of cervical cancer, is now recommended in conjunction with the Pap smear for women of a certain age. The protocol listed below is a general guideline. Your doctor may recommend a different schedule for you. The American Congress of Obstetricians and Gynecologists and the ACS recommend:

Age 21Begin Pap smears regardless of prior sexual history
Ages 21 to 29Repeat Pap smears every 3 years
Ages 30 to 65Repeat Pap smears combined with HPV testing every 5 years or continue Pap smears alone every 3 years
Age 66 and olderDiscontinue screening in women who have had adequate screenings and normal results
After hysterectomyRecommend against screening in women of any age who have had a hysterectomy with removal of the cervix

Women who have been immunized against HPV should continue screening. Vaccination protects against HPV 16 and 18, which are the leading cause of cervical cancer. However, other types of HPV infections cause cervical cancer as well.

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