Cervical cancer is one of the most preventable cancers in the U.S. In fact, as many as 93% of cases could be prevented with regular screenings such as pap smears and vaccination against HPV (human papillomavirus). HPV is the primary cause of cervical cancer, with persistent infections leading to abnormal cell changes that can develop into cancer over time.
Still, every year nearly 13,000 women in the U.S. are diagnosed with cervical cancer. You have probably heard a lot of things about what types of screenings you need and at what age. At Summit Health, we’re here to support and guide you with the care and information you need to take the best steps for your health, every step of the way.
Here are 10 things you need to know about cervical cancer screening:
1. Women should get pap tests starting at age 21.
The first step in protecting your cervical health is to begin Pap tests (or Pap smears) at age 21 as recommended by the U.S. Preventive Services Task Force (USPSTF).
"The evidence shows there’s no benefit to Pap smears for women under 21 and the risk of unnecessary follow-up tests and treatments is higher than the potential benefit," explains Nikole Bobadilla, MD, OB/GYN at Summit Health in Montclair. Even if you're sexually active, cervical cancer is so rare in women under 21 that screening is generally not needed.
2. Screening before age 21 is unnecessary, even if sexually active.
HPV is a common sexually transmitted infection that can affect the genital area, but in most cases, it goes away on its own without causing any harm. While it ’s true that HPV is a common sexually transmitted infection, it usually takes many years for HPV infection to lead to cervical cancer. In fact, the development of cervical cancer is a slow process. Most young women, even those who are sexually active, won’t develop cancer before age 21.
"The HPV infection may resolve on its own, so regular screening before 21 is unnecessary and can cause more harm than good,” says Dr. Bobadilla.
3. The majority of new cervical cancers are diagnosed in women who do not have regular screenings.
More than half of new cervical cancers are diagnosed in women who have never had a Pap test or who haven't been screened in the last five years. This highlights the importance of regular screening as a preventive measure. Women who don’t get screened are at a much higher risk of developing cervical cancer that could have been detected early.
4. Cervical cancer can be prevented with early detection.
One of the most powerful things women can do to protect themselves from cervical cancer is to have regular screenings.
“Cervical cancer is highly preventable with early detection and treatment,” says Dr. Bobadilla. “Pap tests and HPV testing are crucial tools that allow us to detect any abnormal changes early, before they become cancerous.”
5. Women over age 30 have several screening options.
There are three main options for cervical cancer screening: a Pap test, an HPV test, or a co-test (both Pap and HPV tests) in women over 30.
"Each test has its strengths, but HPV testing and co-testing are better at identifying women at risk for cervical cancer," Dr. Bobadilla explains. "However, HPV testing can sometimes result in more false positives, which means more follow-up procedures.” Discuss with your healthcare provider which test is best for your specific health situation.
6. An abnormal pap test doesn’t mean cancer.
It’s important to understand that an abnormal Pap test result doesn’t automatically mean you have cervical cancer. In many cases, the results indicate changes in cervical cells that may not necessarily be cancerous.
Dr. Bobadilla notes, "Most abnormal results are due to low-grade changes that could resolve on their own." If necessary, further tests like a colposcopy or biopsy may be done to assess the severity of the abnormality.
7. Some women need to be screened more often.
Some women need more frequent screenings. Those with a history of cervical cancer, HIV, a weakened immune system, or who were exposed to diethylstilbestrol (DES) before birth may need closer monitoring. DES is a synthetic hormone once given to pregnant women to prevent miscarriages, later linked to increased cancer risk in their daughters. If previous results were abnormal, you may also need more frequent testing.
8. Women over 65: When to stop screening
Women over the age of 65 may be able to stop cervical cancer screening if they’ve had consistent, normal test results in the past. However, women who have had a hysterectomy for benign reasons like fibroids may also stop screening, as long as there’s no history of cervical cancer or dysplasia.
"You don’t need to continue screening if you’ve had three normal Pap tests or two negative HPV tests in the last ten years," explains Dr. Bobadilla.
9. Four out of five women will have HPV at some point.
HPV is very common, with approximately 80% of sexually active women contracting the virus at some point in their lives. The good news? The HPV vaccine can help prevent infection with the most high-risk strains of the virus.
“The vaccine is a highly effective way to protect against the strains of HPV that cause cervical cancer," says Dr. Bobadilla.
10. Vaccinated women still need screening.
Even if you’ve received the HPV vaccine, it’s important to continue cervical cancer screenings.
"The vaccine does not protect against all strains of HPV that can cause cervical cancer," says Dr. Bobadilla. "Routine screening remains essential, even for women who are vaccinated, to ensure early detection of any abnormal changes."
Summit Health is here to help.
At Summit Health, we prioritize your health and well-being. If you have questions or need guidance on cervical cancer screening, our OB/GYN specialists are ready to assist you. Whether you're starting screenings for the first time or need to discuss options based on your individual health, our Montclair hub offers the expertise you need.
Remember, regular screening and preventive care are key to ensuring your reproductive health. Schedule your appointment with Summit Health today!