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Check Your Health is a web-only feature being offered monthly by The Cheshire Herald. Each month, a professional from MidState Medical Center will offer advice on a different issue pertaining to health.
The best way to prevent cervical cancer is to get a pap smear test on a regular basis. This test is performed by having a pelvic exam done by a nurse practitioner, physician’s assistant, or doctor. The cervix is gently swabbed with a small brush and spatula. The collected cells are then sent to the laboratory to be evaluated. If the cells appear abnormal, you will most likely need further testing.
Pap smears are done to identify abnormal cervical cells and precancerous cells that, if left untreated, could lead to invasive cervical cancer. It is estimated that over 12,000 new cases of invasive cervical cancer will be identified this year in the United States. Half of these cases will occur in women who have not been adequately screened. When abnormal or precancerous cervical cells are found, additional procedures can be done to greatly reduce the likelihood of cervical cancer developing.
Cervical cancer is most common in women over the age of 30, and is usually slow growing. Almost all cervical cancer is caused by the human papilloma virus (HPV). This is a very common virus that is spread through sexual contact and intercourse. It is one of the most common sexually transmitted diseases. Over 50 percent of adolescents and young adults will be exposed to HPV. The development of cervical cancer depends on the type of high risk human papilloma virus a woman is exposed to; the number of sex partners she has had; and how long the HPV infection has been there. In most women, the virus is cleared out by the body.
There are several ways to prevent the development of abnormal cervical cells and cervical cancer. Girls (and boys) are recommended to get the HPV vaccine before any sexual exposure (ages 9-26). Always use condoms when having any sexual contact. Do not smoke cigarettes. Fewer numbers of sexual partners is best to limit exposure to HPV, and only one partner at a time. Having sex for the first time after the age of 18 allows the cervix to mature and be more resistant to the HPV.
It is best to schedule your pap test and pelvic exam when you do not have your period. In the 48 hours before your appointment, do not engage in sexual intercourse; do not use tampons; do not douche; and do not use contraceptive jellies, creams, or foams. These guidelines help make the pap test more accurate.
In the past several years, our understanding of HPV and cervical cancer has grown substantially. This has lead to changes in the screening guidelines. It is not necessary to have a pap yearly. Cervical screening should generally start at age 21. A pap smear is done yearly for three years and then can be done every two to three years until age 30, providing the test is normal.
After age 30, a pap smear and HPV test can be done every three to five years. After discussion with your health care provider, women who are over 65 or have had a hysterectomy for non-cervical disease reasons can stop having pap smears. If you have a history of abnormal pap smears, your health care provider will discuss with you how often you should be screened. Women who have HIV, in-utero exposure to DES, or are immune-suppressed may need more frequent cervical pap smears and screenings
A pap smear is done as part of a pelvic exam. Even if you do not need a pap, a pelvic exam screens for other problems and diseases. It is best to have that yearly for most women starting at about age 18. Early detection and prevention is always the best option when it comes to our health!
Deborah A. Molloy, MS, APRN
MidState Medical Group
Women’s Primary Care