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Cervical Cancer Screening: How Often Should You Get Tested?
The two smartest things you can do to help prevent cervical cancer are to get the HPV vaccine, and to get the right test at the right time.
Common Screening Tests for Cervical Cancer
Two tests are widely used to screen for cancer in the cervix, the narrow opening to the uterus at the top of the vagina:
- The Papanicolaou (Pap) test can find abnormal cells early, before they turn into cancer.
- The HPV test looks for the virus that is the main cause of cervical cancer.
Cervical cancer rates have dropped dramatically in the US over the past few decades. This is largely due to increased screening through Pap and HPV test. “Cervical cancer is preventable, said Fox Chase gynecologic oncologist Christina Chu, MD, but you must get screened routinely.”
Many women understand that cervical cancer screening is simple and beneficial, but there is a lot of confusion about how often to get tested. The confusion stems partly from the fact that doctors used to recommend annual Pap screenings for all women – and some still do. But many studies found that for most women, there was no real advantage to getting Pap tests every year. Dr. Chu explained, “In certain patients, moving from yearly Pap tests to screening at longer intervals has shown no drop in the rate of picking up abnormalities, but there has been a decrease in the rate of false positives. False positives create unnecessary stress and require additional follow-up tests.”
When Should You Get Screened for Cervical Cancer?
The American Cancer Society updated their screening guidelines in November of 2020.
These guidelines are designed to avoid unnecessary testing for women whose test results are normal or show only mild, or low-grade, abnormal cells. For individuals with a cervix, here’s what you need to know:
If you are…
American Cancer Society Cervical Cancer Screening Guidelines say…
21 – 65 years old
- Get a primary HPV test every 5 years
OR if a primary test is not available,
- Get an HPV/Pap co-test every 5 years or a Pap test alone every 3 years
Age 66 or older
Stop getting HPV and/or Pap tests if:
- You have no history of moderate or severe abnormal cervical cells or cervical cancer
- You have had negative Pap test results in a row OR 2 negative co-test results in a row within the past 10 years
There are a number of organizations that provide screening recommendations for cervical cancer. While the ACS has recently updated their recommendations to the above, other organizations may recommend a different timeline which includes screening women age 21-29 with a Pap test alone every 3 years and women aged 30-65 with a Pap test and HPV test (co-test) every 5 years or a Pap test alone every 3 years.
It is important to have a conversation with your physician about what cervical cancer screening schedule you should follow.
What if You've Had the HPV Vaccine?
The HPV vaccine is incredibly effective at preventing infection due to the strains responsible for ~80% of cervical cancer. If you have had the HPV vaccine, you still need to follow the cervical cancer screening guidelines for women your age.
“The most important thing to remember is that prevention is better than treatment,” Dr. Chu emphasized. “Get your sons and daughters vaccinated for HPV.”
When is More Frequent Cervical Cancer Testing Needed?
Some women have health issues that put them at higher risk for cervical cancer. You may need to be screened more often – and followed more closely by your doctor – if you:
- Have a history of cervical cancer or abnormal pap tests
- Are infected with HIV (human immunodeficiency virus) or have a weakened immune system
- Were exposed to DES (diethylstilbestrol) before birth
Do You Need to Be Screened for Cervical Cancer if You've Had a Hysterectomy?
If you've had a hysterectomy (surgery to remove your uterus), you may still need cervical or vaginal cancer screening. It depends on several factors. You are more likely to need screening if:
- Your cervix was not removed as part of your surgery
- You had the hysterectomy to remove abnormal or cancerous cells
- You have high-risk HPV infection
Even if your cervix was removed, there may still be some cervical cells at the top of the vagina. If you have a history of cervical cancer or cervical cell changes, you should continue to have screening for 20 years after the time of your surgery.
The Importance of Routine Screening
The good news is that most women who get routine screenings and follow-up care if needed do not develop cervical cancer. Also, regular testing can find cervical cancer at an early stage even if there are no symptoms, and when cervical cancer is found early, it can be curable.
In Dr. Chu’s words, “Get screened, get vaccinated. As women, we have this opportunity to take care of ourselves and our daughters.”