January is Cervical Health Awareness Month which presents the perfect opportunity to discuss cervical cancer screening and recommendations.
The Pap smear is the screening test for cervical cancer and is generally recommended to start at age 21. It is named for Dr. George Papanicolaou, a Greek cytopathologist, who created the test in the late 1920s.
A Pap requires a pelvic exam to collect cells from the cervix. These cells are examined using cytology for normal or abnormal features. When cells appear abnormal, Pap results are reported as abnormal. Abnormal results can be further reported as unsatisfactory, atypical, low-grade, or high-grade.
Another feature of modern cervical cancer screening is testing for Human Papilloma virus (HPV). HPV is an incredibly common sexually transmitted infection that is found in 99% of all cervical cancers. It is estimated that up to 80% of all sexually active individuals has had HPV. Although this number is high, about 90% of HPV infections are cleared within 2 years. Younger women are more likely to clear HPV infections, which is why HPV screening is not recommended in women age 21 to 29. HPV testing can be used, however, to triage certain atypical cytology results in this age group.
The consensus recommendations for cervical cancer screening are provided by the American Society for Colposcopy and Cervical Pathology. These are standard screening guidelines for average risk women.
Depending on your age and risk factors, your cytology results +/- your HPV results will be considered to determine whether your screening is normal or abnormal. This will further determine whether you need repeat testing, more definitive testing, or treatment. Only your qualified healthcare provider can make these determinations as they are customized to each specific person.
So remember, the mere presence of HPV or abnormal cells on a Pap Smear is not cause for panic. An abnormal Pap does not mean that you have cancer. Close follow up and compliance with repeat testing and treatment may seem annoying, but it can prevent you from developing cervical cancer, and that’s pretty incredible.