Cervical Cancer Questions and Answers (cont'd)
Q: I've avoided going to the health care professional for years and never even had a Pap test. What can I expect when I have the test?
A: A Pap test is a simple procedure: After a speculum (the standard device used to examine the cervix) is placed in your vagina, cells are skimmed from the surface of the cervix then smeared onto a glass slide. A sample is taken from the T-zone with a tiny wooden or plastic spatula, or a tiny brush. The cervix is the narrow neck of the uterus that opens into the vagina. For women who have had total hysterectomies, in which the cervix is removed, cells are taken from the walls of the vagina. The slide is delivered to a laboratory where a cytotechnologist (a lab professional who reviews your Pap test slides) and, when necessary, a pathologist (a health care professional who examines bodily tissue samples) examine the sample for any abnormalities. Each smear contains roughly 50,000 to 300,000 cells.
Q: I have cervical cancer and my health care professional has not recommended chemotherapy. I thought it was used for all cancers?
A: Depending on the stage of your cancer, sometimes radiation alone will be recommended as a treatment. However, clinical trials show that the combination of radiation therapy and chemotherapy with cisplatin is more effective than radiation alone for women with stage IB2 cervical cancer. This prompted the National Cancer Institute to recommend that chemotherapy be considered in all patients receiving radiation therapy for cervical cancer larger than four centimeters. If you're unsure of whether chemotherapy is an option for you, talk to your health care professional.
Q: My Pap test was reported as a false negative. What does that mean?
A: When a Pap test fails to detect an existing abnormality, the result is referred to as a false negative. Even under the best of conditions, there is always a small, but irreducible false negative rate. Several factors can contribute to a Pap test reporting a false negative:
- When irregular cells are located high in the cervical canal they are difficult to access under normal Pap test procedures
- Menstrual blood can mask abnormal cells; these cells would not be visible to the cytotechnologist
- An inadequate sample — when not enough cells were collected during the Pap test
- Human error, where the person reviewing the slide misinterpreted abnormal cells as normal
Q: I haven't had a Pap smear in several years because I don't have health insurance and can't afford it. Are there any options for me?
A: The National Breast and Cervical Cancer Early Detection Program provides breast and cervical cancer screening services to underserved women throughout the country, including 13 American Indian/Alaska Native organizations. Services are either free or provided on a sliding scale based on your income. For information about access in your area, call 1-888-842-6355 (select option 7) or log onto www.cdc.gov/cancer/nbccedp.
Additionally, Medicare provides 100 percent coverage for a Pap smear and 80 percent coverage of the pelvic examination once every 24 months. If you are at high risk for cervical or vaginal cancer, or if you are of childbearing age and have had an abnormal Pap smear in the preceding 36 months, Medicare covers these tests every 12 months.
Last medical review: 6/06
Last date updated: 1/07
Copyright 2007 National Women's Health Resource Center Inc. (NWHRC)
