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Cervical Cancer

Cancer in cervical cells doesn’t occur overnight – the cells go through a process of changes before they become cancerous. Much of the time, these precancerous cells don’t become cancer. But if these precancers are treated, almost all true cancers can be prevented.

Every woman should begin cervical cancer screening about three years after she starts having intercourse, or at least by age 21. A Pap test should be performed every year or every two years, if using the newer liquid-based Pap test.

Starting at age 30, if you have three normal Pap smears in a row can get the Pap test every two to three years instead of yearly. However, women with risk factors for cervical cancer (DES exposure before birth, HIV infection, or a weakened immune system due to organ transplant, chemotherapy, or chronic steroid use) should continue to be screened every year.
Women age 70 and older who have had three or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years can choose to stop having cervical cancer screening. But if you have a history of cervical cancer, DES exposure before birth, HIV infection or a weakened immune system, and you remain in good health, you should continue to have screening.
If you have had a total hysterectomy (removal of the uterus and cervix), you may choose to stop having cervical cancer screening -- UNLESS the surgery was done as a treatment for cervical cancer or precancer. Women who have had a hysterectomy without removal of the cervix should continue to follow the guidelines above.

What Is a Pap Test?
The Pap test, or Pap smear, is a way to check cells from the cervix (the lower part of the uterus or womb) and the vagina in order to spot precancerous changes or cancer of the cervix or vagina. During the test, a tube called a speculum holds the vagina open so your healthcare provider can see your cervix. While the speculum is in place, your doctor will scrape cells from your cervix with a small spatula. A small brush or swab is used to take a sample of the cells. These cells will be examined by specially trained technologists or doctors under a microscope at a lab.

How to Prepare Before a Pap Smear

Don't use tampons, birth-control foams, jellies or other vaginal creams for two to three days before the test.
There is no need to douche at all, but if you do, don't douche for two to three days before the test.
Do not have sexual intercourse for two days before the test.
Try not to schedule your Pap test during your menstrual period. The best time is at least five days after your menstrual period stops.

Without taking these precautions, your Pap smear results may be inaccurate.

Source: American Cancer Society

You can find more information about Pap Tests in our Health Library »

Risk Factors for Cervical Cancer
Several risk factors increase your chance of developing cervical cancer. In considering these risk factors, it helps to focus on those that you can change or avoid (such as smoking and sexual behaviors that can lead to human papillomavirus infection), rather than those that you cannot (such as differences in age and family history). However, understanding risk factors that cannot be changed is still important because it can convince women with these factors to get a Pap test for early detection of cervical cancer. Cervical cancer risk factors include:

Age: The average age of women newly diagnosed with cervical cancer is between 50 and 55 years. This cancer rarely occurs in girls younger than 15. It begins to appear in women in their 20s. Cervical cancer is different from most cancers that tend to occur more often as people get older. Although cervical cancer does affect young women, many older women do not realize that their risk of developing cervical cancer does not go down as they age and that it is important for them to continue having Pap tests.
Human papillomavirus infection (HPV): The most important risk factor for cervical cancer is infection by the human papillomavirus. HPVs are a group of more than 100 types of viruses. Different HPV types cause genital warts, and about half a dozen HPVs have been linked with genital or anal cancers in both men and women. Certain types of sexual behavior increase a woman's risk of getting HPV infection, such as having unprotected sex at any age; having intercourse at an early age; and having many sexual partners. HPV infection does not always produce warts or other symptoms; so you can be infected with HPV and pass it on without knowing it. Recent studies show that condoms ("rubbers") cannot completely protect against HPV infection.
Smoking: The cancer-causing chemicals inhaled during smoking affect more than just your lungs. In fact, tobacco by-products have been found in the cervical mucus of women who smoke. Women who smoke are about twice as likely as nonsmokers to get cervical cancer.
Human immunodeficiency virus (HIV) infection: HIV is the virus that causes the acquired immunodeficiency syndrome (AIDS). Because this virus damages the body's immune system, it makes women more susceptible to HPV infections, which may increase the risk of cervical cancer. In women infected with HIV, a cervical precancer might develop into an invasive cancer faster than it normally would.
Chlamydia infection: Chlamydia is a relatively common kind of bacteria that can infect the female reproductive system. It is spread by sexual contact. Although infection may cause symptoms, many women do not know they are infected unless samples taken at the time of their Pap test are analyzed for this type of bacteria.
Diet: Women with poor diets may be at increased risk for cervical cancer. Diets low in fruits and vegetables are associated with an increased risk of cervical cancer and several other cancers.
Low socioeconomic status: Low socioeconomic status is also a risk factor for cervical cancer. Many women with low incomes do not have ready access to adequate health care services, including Pap tests and treatment of precancerous cervical disease. Such women may also be undernourished, which may play a role in increasing their risk.
Diethylstilbestrol (DES): DES is a hormonal drug that was prescribed between 1940 and 1971 for some women thought to be at increased risk for miscarriages. About one out of every 1,000 women whose mother took DES when pregnant with them will develop cancer (clear-cell adenocarcinoma) of the vagina or cervix.
Family history of cervical cancer: Recent studies suggest that women whose mother or sisters have had cervical cancer are more likely to develop the disease, themselves. Some researchers suspect this familial tendency is due to an inherited condition that makes some women less able to fight off HPV infection than others.