Cervical cancer used to be the top cause of cancer death for women in the United States. It now consistently ranks much lower, thanks in large part to the safe and highly effective HPV vaccine as well as routine cervical cancer screenings.
How often you go for your cervical cancer screening will depend on your age and other risk factors. For the most part, people with cervixes who are between ages 21 and 29 should get a Pap test every three years. Those who are ages 35 to 65 should also be screened every three or five years depending on the type of test they get and their individual risk factors for the disease.
What is cervical cancer screening?
Cervical cancer screening means checking for cervical cancer before you have any symptoms. If you start to develop cancer, getting screened on a regular basis can help catch it early when treatments tend to work best.
There are two types of tests that can tip off your healthcare provider (HCP) to cervical cancer. These are the Pap test and the HPV test. The Pap test involves collecting a small sample of cervical cells, often during your routine gynecology exam, to look for cell changes that could mean cancer is developing. The HPV test involves checking that same sample for the top 13 to 14 types of HPV, a common virus known as human papillomavirus that can lead to cervical cancer.
People in your age group usually only need to have a Pap test. You should get your first Pap test at age 21. If your test comes back negative, or shows no signs of cancer, you don’t have to do it again for another three years. You’re able to wait a few years because cervical cancer tends to grow slowly, and it can take about three to seven years for abnormal cervical cells to become cancer.
“It is recommended for younger women to get tested every three years by Pap test only, and not with the HPV test,” says Jessica Wells, PhD, RN, assistant professor at the Nell Hodgson Woodruff School of Nursing at Emory University in Atlanta, Georgia, specializing in women’s health and cancer prevention. “That’s because if you are exposed to HPV at this age, the chance that your body clears (or gets rid of) HPV on its own is very high. So, HPV testing is not typically beneficial in this group.”
Are there any risks to screening?
All screening tests have risks and benefits and it’s important to understand them both. Cervical cancer screening is no exception. Check in with your HCP before making a decision about how often to get tested. The key is to weigh the risks that come from screening against the risk of potentially developing cervical cancer.
Possible downsides to cervical cancer screening include:
Unnecessary testing: If your screening shows you have abnormal cells that could become cancer, you’ll need to go for more testing or treatments. These can be expensive, time-consuming and uncomfortable—and it’s very common for abnormal cells and/or HPV to go away on their own, especially in younger women.
False negatives: Sometimes a screening test can come back negative, suggesting you don’t have cancer, when in fact you really do. A false negative result can delay care when you need it, which can allow cancer to grow and potentially spread.
False positives: A screening test can also turn up positive, suggesting you have cancer, when in fact you really don’t. This can cause you to go for tests and treatments that you don’t need.
Despite the possible downsides, the benefits of screening far outweigh the risks for most people. Regular screening has been shown to detect cancers early and save lives.
What if I’ve had the HPV vaccine?
The HPV vaccine offers protection against HPV and the several cancers it can cause. People often wonder if they still need to go for routine cancer screenings after they’ve been vaccinated for HPV. The answer is yes. You still need to have routine screenings.
“HPV is a virus that has many different strains,” says Wells. “There are actually hundreds of different strains. The Gardasil 9 vaccine [the leading HPV vaccine] protects you against the nine most common strains seen globally, including the seven that are commonly associated with cervical cancer and two associated with genital warts.”
That means that while the HPV vaccine can lower your odds of developing several cancers, it can’t protect you against all of them. What’s more, not every cervical cancer is caused by HPV, so you must still watch for the other types through routine screening.
Rose Hayes, MA, RN, is a registered nurse specializing in patient education and nursing innovation. She is Director of Engagement at Emory School of Nursing.
