What is cervical cancer?
The cervix is the opening of the uterus, and is located at the back of the vagina.
Cells of the cervix can undergo malignant, or cancerous, transformation, potentially leading to cancer and death.
Why should I care?
Cervical cancer is the 2nd most common cancer in women worldwide, after breast cancer.
Cervical cancer can be deadly.
However, several preventative and screening options are available, which have decreased cervical cancer deaths by 80% in developed countries.
Research has shown that 99% of cervical cancer is caused by high-risk strains of a virus called the human papillomavirus (HPV), which is typically transmitted sexually.
A vaccine has been developed to protect against HPV infection, and is now recommended in all adolescents (male AND female) starting at age 11.
What are the symptoms of cervical cancer?
Early cervical cancer often does not cause any symptoms - which is why screening is so important
Later symptoms of cervical cancer are variable, but can include abnormal vaginal bleeding, back or pelvic pain, difficulty urinating, or blood in the urine.
What do I need to do?
A test called a papanicolaou (pap) smear is a way of visualizing the cells of the cervix.
Early recognition of abnormal cells via pap smear can lead to treatment and prevention of developing cancer.
How often should I get a pap smear?
Pap smear screening should start at age 21.
Current guidelines vary, however, for average risk women ages 21-29 with no history of abnormal pap smears, every 3 years (using cytology alone) is sufficient. For average risk women ages 30-65, every 5 years (using cytology and HPV co-testing) is sufficient.
For average risk women with no history of abnormal screenings, pap smears should not be continued after age 65.
If you have an abnormal pap test, screening intervals vary, but may be as frequent as every 12 months.
What should I expect during my first pap smear?
Your doctor will examine your vulva and vagina. A tool called a speculum will be used to help your doctor visualize your cervix. This can sometimes be uncomfortable, but should not be painful.
Your doctor will take a tiny sample of cells from your cervix using a small brush. These cells will be sent to the lab to be looked at under a microscope.
Typically, your doctor will also check your internal organs (uterus and ovaries) using a gloved hand.
The entire exam usually only takes about 5 minutes.
References:
“Cervical cancer.” TIMOTHY P. CANAVAN, M.D., and NIPA R. DOSHI, M.D., Lancaster General Hospital, Lancaster, Pennsylvania. Am Fam Physician. 2000 Mar 1;61(5):1369-1376.
“Cervical cancer screening.” CAITLYN M. RERUCHA, MD, Carl R. Darnall Army Medical Center, Fort Hood, Texas. REBECCA J. CARO, DO, Bassett Army Community Hospital, Fort Wainwright, Alaska. VERNON L. WHEELER, MD, Carl R. Darnall Army Medical Center, Fort Hood, Texas. Am Fam Physician. 2018 Apr 1;97(7):441-448.
“Your first gynecologic visit.” The American College of Obstetricians and Gynecologists. FAQ150, May 2017.