Cervical & Vaginal Cancer Screening
Cervical cancer occurs when the cells of the cervix grow abnormally and invade other tissues and organs of the body. When it is invasive, this cancer affects the deeper tissues of the cervix and may have spread to other parts of the body. Cervical cancer is rare before age 21.
Who is at risk
The risk of developing abnormal changes is associated with infection with human papillomavirus (HPV). In addition, early sexual contact, multiple sexual partners, and taking oral contraceptives (birth control pills) increase the risk of cervical cancer because they lead to greater exposure to HPV.
Other risk factors include HIV infection, a compromised immune system, in utero exposure to diethylstilbestrol, and previous treatment of a high-grade precancerous lesion or cervical cancer.
Seek medical care if you have any of these symptoms that may indicate cervical cancer.
- Pain, when the cancer is advanced
- Abnormal vaginal bleeding (other than during menstruation)
- Abnormal vaginal discharge
- Pelvic pain
- Kidney failure due to a urinary tract or bowel obstruction, when the cancer is advanced
What you can do
Avoiding risk factors and increasing protective factors may help prevent cancer.
Preventive service at no cost
Women aged 21 to 65 years
The USPSTF recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus (hrHPV) testing alone, or every 5 years with hrHPV testing in combination with cytology (cotesting).
Why screening is important
As in many cancers, you may have no signs or symptoms of cervical cancer until it has progressed to a dangerous stage. Screening aims to identify high-grade precancerous cervical lesions to prevent progression to cervical cancer.
High-risk HPV infection is associated with nearly all cases of cervical cancer, and women are exposed to hrHPV through sexual intercourse. Although a large proportion of HPV infections resolve spontaneously, the high likelihood of exposure to hrHPV means that women are at risk for precancerous lesions and cervical cancer.
What the screening is
A Pap test is a procedure to collect cells from the surface of the cervix and vagina.
An HPV test is a laboratory test that is used to check DNA or RNA for certain types of HPV infection. Cells are collected from the cervix and DNA or RNA from the cells is checked to find out if there is an infection caused by a type of human papillomavirus that is linked to cervical cancer. This test may be done using the sample of cells removed during a Pap test. This test may also be done if the results of a Pap test show certain abnormal cervical cells. When both the HPV test and Pap test are done using cells from the sample removed during a Pap test, it is called a Pap/HPV cotest.
The Centers for Disease Control and Prevention’s Advisory Council on Immunization Practice recommends routine HPV vaccination. A 2-dose schedule is recommended for girls and boys who initiate the vaccination series at ages 9 to 14 years. Three doses are recommended for girls and boys who initiate the vaccination series at ages 15 to 26 years and for those who have a compromised immune system.
High-grade cervical lesions may be treated with excisional and ablative therapies. Early-stage cervical cancer may be treated with surgery (hysterectomy) or chemotherapy. Treatment of precancerous lesions is less invasive than treatment of cancer.