The purpose of screening is early diagnosis and treatment. Screening tests are usually administered to people without current symptoms, but who may be at high risk for certain diseases or conditions.
The number of new cases and deaths due to cervical cancer is decreasing each year. Experts agree that this is due to early detection and treatment. Early detection and treatment are possible due to the widespread availability and use of cervical cancer screening methods—the pelvic exam, Pap test, and human papillomavirus (HPV) test.
This test is performed in a doctor’s office. You will change into a dressing gown and lie back on the examination table. There will be stirrups at the end of the table where you can rest your feet. The doctor may complete other aspects of a physical exam first, including examining your thyroid gland, heart, lungs, breasts, and abdomen. As part of the pelvic exam, your external genitalia will be examined for signs of infection or redness. Next, the doctor will slide a speculum into your vagina. The speculum allows the vagina to be opened slightly. This should not hurt or pinch, but may be uncomfortable. You also may feel a bit nervous or anxious. Try to take slow, deep breaths to help yourself relax.
At this point, the doctor will perform a Pap test (see below for a description of this procedure). The doctor may also perform additional tests at this time to check for bacterial or viral infections, such as HPV, chlamydia, or gonorrhea.
After the doctor is done, the speculum will be removed. The doctor will then place two gloved fingers into your vagina while pressing on your lower abdomen. This identifies the size, shape, and position of your uterus, fallopian tubes, and ovaries. The doctor may then place one finger in your vagina and one finger in your rectum to examine the tissues separating those organs.
You should not feel pain during the exam, but you may experience a pressure discomfort. If you are experiencing pain, tell your doctor. You may have a trace of vaginal bleeding afterwards from irritation of your cervix.
The Pap test is performed during the pelvic exam. Once the doctor has inserted the speculum into your vagina, your cervix will be visible. The doctor will use a flat stick or a soft brush to collect a sample of cells from the outer cervix and its canal. These cells are placed on a slide or suspended in a solution and sent to a laboratory for evaluation. Your doctor should have the results of your Pap test in 1-3 weeks. If any abnormalities are found, your doctor will call you and discuss follow-up care.
Prior to your scheduled pelvic exam and Pap test, it is important to keep in mind the following things:
- Do not schedule the Pap test during your menstrual period. If possible, schedule it two weeks after the first day of your period.
- Do not use vaginal creams, medications, or douches for 72 hours before the test.
- Do not use contraceptives, such as spermicidal foams, creams, or jellies, for 72 hours before the test.
- Do not have intercourse for 24 hours before the test.
Human Papillomavirus (HPV) Test
HPV is a very common sexually transmitted disease that can cause changes in cervical cells. In some cases, these changes can lead to cancer. The HPV test, which can be used along with the Pap test, screens women for the HPV virus. The same sample of cells taken for the Pap test can also be tested for HPV.
If you are aged 30 or older, you should have a Pap test along with a test to check for HPV every 5 years. Alternately, you may have the Pap test alone every three years.
When To Get Screened
If you are a healthy woman without prior cervical intraepithelial neoplasia 2 or worse, many professional health organizations offer these recommendations for screening:
- If you are aged 21-29 years—It is recommended that you have the Pap test every three years.
- If you are aged 30-65—It is recommended that you have the Pap test along with the HPV test every five years. (Or, you can continue to have just the Pap test every three years.)
- If you are aged 65 or older—You may be able to stop having Pap and HPV tests if you have had normal results (for example, three normal results in a row and no abnormal results in the past 10 years)
- If you have had a hysterectomy with removal of your cervix no screening is needed.
Note: You will need to have Pap tests done more often if you have abnormal results or certain conditions, such as:
- Suppressed immune system
- Exposure to diethylstilbestrol (DES) in utero (in the womb)—an estrogen-like substance that was given to prevent miscarriages in high-risk pregnancies
- History of cervical dysplasia or cervical cancer
Talk to your doctor about the right screening schedule for you.
- Reviewer: Michael Woods, MD
- Review Date: 12/2013 -
- Update Date: 03/17/2014 -