Screening to check for cervical changes before there are symptoms is very important. Screening can help the doctor find abnormal cells before cancer develops. Finding and treating abnormal cells can prevent most cervical cancer. Also, screening can help find cancer early, when treatment is more likely to be effective.

For the past several decades, the number of women diagnosed each year with cervical cancer has been falling. Doctors believe this is mainly because of the success of screening.

Doctors recommend that women help reduce their risk of cervical cancer by having regular Pap tests. A Pap test (sometimes called Pap smear or cervical smear) is a simple test used to look at cervical cells. For most women, the test is not painful. A Pap test is done in a doctor's office or clinic during a pelvic exam. The doctor or nurse scrapes a sample of cells from the cervix, and then smears the cells on a glass slide. In a new type of Pap test (liquid-based Pap test), the cells are rinsed into a small container of liquid. A special machine puts the cells onto slides. For both types of Pap test, a lab checks the cells on the slides under a microscope for abnormalities.

Pap tests can find cervical cancer or abnormal cells that can lead to cervical cancer. Doctors generally recommend that:

• Women should begin having Pap tests 3 years after they begin having sexual intercourse, or when they reach age 21 (whichever comes first).
• Most women should have a Pap test at least once every 3 years.
• Women aged 65 to 70 who have had at least three normal Pap tests and no abnormal Pap tests in the past 10 years may decide, after speaking with their doctor, to stop cervical cancer screening.
• Women who have had a hysterectomy (surgery) to remove the uterus and cervix, also called a total hysterectomy, do not need to have cervical cancer screening. However, if the surgery was treatment for precancerous cells or cancer, the woman should continue with screening.

Women should talk with their doctor about when they should begin having Pap tests, how often to have them, and when they can stop having them. This is especially important for women at higher-than-average risk of cervical cancer.

Some activities can hide abnormal cells and affect Pap test results. Doctors suggest the following tips:

• Do not douche for 48 hours before the test.
• Do not have sexual intercourse for 48 hours before the test.
• Do not use vaginal medicines (except as directed by a doctor) or birth control foams, creams, or jellies for 48 hours before the test.

Doctors also suggest that a woman schedule her Pap test for a time that is 10 to 20 days after the first day of her menstrual period.

Most often, abnormal cells found by a Pap test are not cancerous. However, some abnormal conditions may become cancer over time:

• LSIL (low-grade squamous intraepithelial lesion): LSILs are mild cell changes on the surface of the cervix. Such changes often are caused by HPV infections. LSILs are common, especially in young women. LSILs are not cancer. Even without treatment, most LSILs stay the same or go away. However, some turn into high-grade lesions, which may lead to cancer.
• HSIL (high-grade squamous intraepithelial lesion): HSILs are not cancer, but without treatment they may lead to cancer. The precancerous cells are only on the surface of the cervix. They look very different from normal cells.

The NCI booklet Understanding Cervical Changes has more information about abnormal Pap test results. You also may want to read the brochure Having a Pelvic Exam and Pap Test and the NCI fact sheet "The Pap Test: Questions and Answers."

Back to Top

< Previous Section  |  Next Section >