Let’s face it. No one wants to visit the gynecologist for an annual pap smear. This uncomfortable visit is not anyone’s favorite way to spend their time. But regular pap smears for cervical cancer prevention can save lives.
More than 13,000 US women are diagnosed with cervical cancer each year. In most cases, cervical cancer can be prevented through vaccination and proper cervical screening.
Despite screening programs, 4,000 US women die from HPV-related cervical cancer each year.
What is the point of a pap smear?
A pap (Papanicolaou) smear is a screening test for cervical cancer. The cervix is the opening of the uterus located at the back of the vagina. During a pap smear, doctors place a device called a speculum into the vagina.
The speculum opens the walls of the vagina allowing visualization of the cervix. Cervical cells are then collected using a small brush. These cells are sent to a lab for analysis.
The cells are processed under a microscope to evaluate for precancerous changes called cervical dysplasia. The goal of pap screening is to detect abnormal cervical changes so we can intervene long before cervical cancer develops.
Do I need an HPV test with my pap?
In addition to analyzing the cervical cells, doctors often perform an HPV test. HPV testing recommendations vary depending on your age. HPV testing is recommended for standard screening in women over 30.
HPV testing is also triggered when an abnormal pap smear is found in women under 30. Cervical dysplasia (precancerous cells of the cervix) are linked to the Human papillomavirus (HPV).
Statistically, 80% of Americans will contract HPV, making it the most common sexually transmitted infection. This means more of us will contract this STI than those who do not. HPV “co-testing” during pap smear helps guide the management steps when an abnormality occurs.
Around 40 of the known 130 known strains of HPV affect the genital tract. In men and women, HPV causes genital warts, and persistent strains can lead to cervical, penile, vaginal, anal, mouth, throat, and neck cancer. Approximately 20,000 women and 12,000 men develop cancer caused by HPV every year in the United States.
Who is at risk for HPV?
Anyone sexually active is at risk. The virus may stay dormant for years. Symptoms may not appear until long after you have sex with someone previously infected. It is rarely possible to know when you first became infected. You can not play the blame game with HPV.
Sexually transmitted HPV types fall into two groups, low risk and high risk.
- Low-risk HPVs mostly cause no disease. However, a few low-risk HPV types can cause warts on or around the genitals, anus, mouth, or throat.
- High-risk HPVs can cause several types of cancer. There are about 14 high-risk HPV types. Two of these, HPV16 and HPV18, are responsible for most HPV-related cancers.
Long-lasting infections with high-risk HPVs can cause cancer in parts of the body where HPV infects cells, such as in the cervix, mouth, throat, anus, rectum, penis, vagina, and vulva.
The HPV vaccine and keeping your pap smears up to date are our best tools to impact cervical disease and HPV.
There is no cure or medication for HPV. The most effective way to protect yourself from HPV infection is to get vaccinated. The HPV vaccine is FDA approved for men and women age 9–45. The Center for Disease Control recommends that the vaccine be given as early as 11 or 12.
HPV vaccination is recommended by the Centers for Disease Control and Prevention (CDC)’s Advisory Committee on Immunizations Practices (ACIP) to prevent new HPV infections and HPV-associated diseases, including some cancers.
The vaccine is most effective when given before initiating sexual activity. It is still useful for those already sexually active as very few have already been exposed to the nine strains of HPV covered in the vaccine.
The most recent recommendations extended the age from 26 to 45, but insurance coverage for those in this age group is lagging.
Pap smears allow for early detection of disease
When a pap smear comes back abnormal, there is no reason to hit the panic button. The next step is a microscope exam called a colposcopy procedure. A colposcopy is an office procedure that allows your doctor to visualize the cervix more closely using a microscope. The colposcope identifies abnormal cervical tissue that cannot be seen with the naked eye.
This office procedure helps determine where on the cervix the abnormal cells are coming from and how severe the abnormality is.
If an area of the cervix appears concerning or precancerous, the doctor can sample the area with a biopsy during the exam.
If the biopsy shows a precancerous lesion, your healthcare provider may recommend a LEEP (loop electrosurgical excision procedure.)
A few minutes of discomfort can save your life
Pap smears save lives. Period. No one likes to get this test, but the benefits of early detection and prevention outweigh the risks of avoiding it.
If it is time for you to update you pap smear, it is well worth your time to do it. A pap smear could save your life.