Cervical Cancer Questions and Answers
Here are answers to some frequently asked questions about cervical cancer.
Don't panic. There are many things that can produce an abnormal result. To improve the reliability of the test, schedule your appointment two weeks after your menstrual period and refrain from having intercourse, or using vaginal contraceptives or douches for at least 48 hours before the test.
Q: I've already gone through menopause. Should I continue to have Pap tests?
A: Current guidelines suggest that if you are age 65-70 or older and your last three Pap tests were normal, you can stop having Pap tests; however, annual pelvic exams are still recommended.
Q: My health care professional has recommended a hysterectomy for invasive cervical cancer. How do I know if this is the right thing to do?
A: There are a number of diagnostic steps your health care professional should take before surgery, including a colposcopy and biopsy. Treatment regimens are always your choice and should be discussed thoroughly with your health care professional. Additionally, you should seek a second opinion from a gynecological oncologist before undergoing any surgical procedure. A gynecological oncologist is an obstetrician-gynecologist who has had special training in the care of women with cancers of the cervix, ovary, uterus and vulva.
Q: Is it true that there are new tests to replace the Pap smear?
A: There are several new technologies, but most are designed to improve the reliability of the Pap test, which is still the most widely used screening test to detect changes in cervical cells. Pap tests, like other early detection tests, are not 100 percent accurate. Still, when performed properly, the Pap smear detects a significant majority of cervical cancers — usually in the early stages when the likelihood of a cure is the greatest.
Q: How often should I have a Pap test?
A: The American Cancer Society recommends that screening begin three years after the beginning of vaginal intercourse, but no later than 21 years of age. If your health care professional uses regular Pap tests, you should continue annual screenings to age 30. If a liquid-based Pap test is used, screening can be performed every two years, provided results are normal. Once a woman turns 30 and has had three consecutive "normal" Pap tests, she can be screened every two to three years.
Women over 30 may also want to consider an HPV screening test that uses DNA-based technology to detect HPV in addition to the Pap test. The DNA-HPV screening may be performed at the same time as the Pap test.
However, women who are at an increased risk for developing cervical cancer (those with new or multiple sexual partners) should be screened more frequently. Women who have abnormal Pap test results should discuss subsequent tests and follow-up with their health care professionals.
Women who are 65-70 years or older and have had three previously normal Pap test results and no abnormal results in the past 10 years may stop screening for cervical cancer altogether.
Women who have had a total hysterectomy (removal of the uterus and cervix) may also stop screening unless the hysterectomy was performed because of cervical cancer or pre-cancer-related reasons, or you have a history of abnormal Pap smears. If the hysterectomy was performed to treat cervical cancer, more frequent Pap screenings may be recommended.
