Cervical cancer used to be a major cause of cancer death in women in the U.S. However, with the establishment of regular Pap smear screenings, that death rate has decreased by more than 50%.
Almost all cervical cancer is caused by the human papilloma virus, or HPV. There are many different strains of HPV, and more than 30 types can infect the genital area. The low-risk strains cause genital warts. The high-risk ones can cause cervical dysplasia and cervical cancer, as well as vulvar, vaginal and anal cancers, and penile and anal cancers in males. HPV is sexually transmitted and is commonly transmitted; as many as 70% of women have been infected in their lifetime. However, our immune systems are pretty efficient. Almost 70% of women who tested positive for HPV eventually had resolution. The majority of untreated mild dysplasia regresses within two years. High-grade changes take about 3 to 7 years to progress to cancer, so by catching dysplasia with regular Pap smears, you’re well-protected from cervical cancer progression.
Cervical cancer screening guidelines
Women should get their first Pap smear when they turn 21. In a Pap smear, which is named after Dr. Papanicolaou who invented the procedure, a sample of cervical cells is obtained during a pelvic exam and looked at to see if they look abnormal. Women who are younger than 30 years old should get a Pap smear every 3 years. Under the old guidelines, yearly Pap smears were recommended, so this is a welcome change to many women. Women who are 30 years of age or older can extend the time between screenings to 5 years by also getting tested for HPV in the Pap smear sample.
It’s not recommended for women younger than 21 to get Pap smears, and it’s not recommended that women younger than 30 get tested for HPV. Most women can stop getting Pap smears when they turn 65. Of course, these recommendations change if you have an abnormal result or have certain risk factors.
If you’ve had a hysterectomy, find out whether your cervix was left intact or removed as well. If it was removed, you will most likely not need any more Pap smears.
To find out your individual screening guidelines, make sure to discuss with your healthcare provider.
Abnormal Pap smear results
An abnormal Pap may be followed with a colposcopy, when a gynecologist will look at your cervix under magnification to isolate any abnormal areas.
It’s important to keep in mind that an abnormal Pap smear result doesn’t mean you have cancer. The cells may look abnormal because of an infection or inflammation. Many abnormal changes return to normal on their own. Even if they don’t, it takes years for these changes to become cancerous. But the best way to prevent cervical cancer is by regular screening, so don’t be afraid to get regular pelvic exams at the recommended times.
The HPV vaccine
There are several HPV vaccines available for girls and young women to protect them against both high-risk HPV strains that can cause cervical, vaginal, vulvar and anal cancers. Some also protect against the strains that cause genital warts. Some of these vaccines have even been approved for males to protect them from genital warts, penile and anal cancers.
They are not effective in women who already have HPV, and are approved for use in women up to 26 years of age. However, they may be effective in preventing cervical cancer in women up to 45 years of age.
Women who have had the HPV vaccine should still get regular Pap smears.
If you would like to schedule a women’s wellness exam with Dr. Ochi, please schedule by calling 425-679-6056.