Introduction

What is Cervical Cancer?

What Causes Cervical Cancer?

Who Can Develop Cervical Cancer?

How Can a Woman Help Prevent Cervical Cancer?

What is a Pap Test?

What to Expect During a Pap Test

Find Out Your Pap Test Results

Pap Test Tips to Remember

Where Do I Get a Pap Test?

How Do I Pay for a Pap Test?

Frequently Asked Questions

For More Information

Letter to Vietnamese Women

[In Vietnamese]

I learned about cervical cancer when my friend died from it. After that, the women in my family started to talk about this disease.

My family is religious. My aunt said, "We cannot stop fate. What will be, will be." In some cases, I think this is true. But not with cervical cancer.

My friend is a doctor. She told me that a Pap test can prevent cervical cancer when you get the test regularly and follow up with your doctor as needed. I am glad to know that there is something we can do. Now all the women in my family have Pap tests regularly… - not just once. We do not want to lose a family member to cervical cancer!

It was a little embarrassing at first to get the test. But I had a Pap test because I think nothing could be worse than the pain I felt when my friend died too soon from cervical cancer. I come from a family of very strong women and when something is important for our family, we do it!

I tell every woman - especially Vietnamese women - to get a Pap test at least every 3 years and follow up with their doctor for the results. And get treatment if they need it. Pap tests save lives.

Sincerely,
Mrs. Le Thi Lam

Back to Top Introduction

Each year over 10,000 women in the United States are diagnosed with cervical cancer. Vietnamese-American women get cervical cancer more often than most other women.

There is something you can do to prevent cervical cancer.

There is a simple, 5-minute test called the Pap test (or Pap smear). This test looks for abnormal changes in the cells of the cervix that could lead to cancer if left untreated. If cell changes are found early and treated, cervical cancer can be prevented. Many Vietnamese women do not get regular Pap tests. Most women who die from cervical cancer never had a Pap test.

This brochure has information about cervical cancer that EVERY Vietnamese woman should know to protect her health.

Back to Top What is Cervical Cancer?

Cervical cancer begins in the cells of the cervix. Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die and new cells take their place. Sometimes, this process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a tumor, which can be cancer.

The cervix is the narrow, lower part of the uterus (where the baby grows when a woman is pregnant). The cervix is made up of cells that are easily tested with a Pap test.

Cervical cancer usually develops slowly. Before cancer appears, the cervix goes through slight changes where cells that are not normal begin to appear. Later, these abnormal cells can become cancer cells and start to grow and spread.

Thanks to modern medicine, cervical cancer can be treated if it is found early. In many cases, cancer can be prevented altogether.

"If I have no symptoms, why should I go see my doctor?"

Doctor Nguyen: "Many women may have cervical cancer without knowing it because there are no symptoms at first. I tell all women to make an appointment to get a Pap test even if they have no symptoms. Remember, if it is detected early, cervical cancer can be cured almost 100 percent of the time."

Back to Top What Causes Cervical Cancer?

Almost all cervical cancer begins as an infection from a virus called human papillomavirus (HPV). HPV is sexually transmitted. It is common in women and men. Cervical cancer is not caused by poor hygiene after sex.

What is HPV? Human papillomavirus (pap-ih-LO-ma- VYE-rus) is a virus that is sexually transmitted. There are more than 100 different kinds of HPV. Some of them produce noncancerous warts. Some types of HPV are related to cervical cancer. A Pap test can detect early cell changes caused by HPV before they lead to cervical cancer.

"I always use a condom. Should I worry about getting HPV?"

Doctor Nguyen: "A condom does not effectively protect against HPV. Even when a condom is used, HPV can be transmitted through sexual contact, including vaginal and anal intercourse, finger to genital contact and finger to anal contact."

Back to Top Who Can Develop Cervical Cancer?

Any woman can develop cervical cancer. Women who do not have regular Pap tests have a higher risk of cervical cancer. Vietnamese women in the United States have a high risk of getting cervical cancer because many do not get regular Pap tests.

Back to Top How Can a Woman Help Prevent Cervical Cancer?

A Pap test is the best way you can protect yourself from cervical cancer. You should have a Pap test at least once every 3 years, beginning by age 21. Women who have sex before age 21 should get a Pap test approximately 3 years after the first time having sex.

If you turn 21 years old and have not had sex yet, you should still get a Pap test. You should continue to have Pap tests at least once every 3 years throughout your life. Depending on the results, your doctor may recommend that you have the test more often than that.

Back to Top What is a Pap Test?

A Pap test is a very simple way to test the cervix for abnormal changes in cells that could lead to cancer if not treated. A Pap test is almost always done with a pelvic exam. The Pap test does not detect sexually transmitted diseases. Ask your doctor if you want other tests for these.

What is a pelvic exam? During a pelvic exam, the female reproductive organs are checked for changes in size or shape.

Back to Top What to Expect During a Pap Test

Before the exam: Your doctor will leave the room. You will remove your clothes, put on a gown, and put a sheet over your waist and legs for privacy.

During the exam: Your doctor will insert a small instrument, called a "speculum," into the vagina to see the cervix. Your doctor will then use a small swab to collect cells from your cervix. You may feel a little discomfort.

After the exam: Your doctor will send the cells to a lab to see if there are any abnormal cell changes. Your doctor will follow up with you by phone or mail with your Pap test results. If your doctor does not follow up with you within a week or two after your Pap test, it is important to contact him or her to get your results.

"I am embarrassed to ask for a Pap Test. What should I do?"

Doctor Nguyen: "Many women are embarrassed to remind their doctors to do Pap tests. Because of our culture, we are not used to talking about sexual matters and intimate body parts. So, it takes a brave woman to ask her doctor for a Pap test, especially if her doctor is a man. You can ask for a female provider, such as a nurse, to be in the room. For your health, try not to be embarrassed - simply ask your doctor to do a Pap test."

Back to Top Find Out Your Pap Test Results

It is very important to follow up with your doctor to get the results of your Pap test. Every doctor will have his or her own method of giving patients Pap test results. Before you leave, ask your doctor how you will be notified of the results. If your doctor does not contact you with your results within a week or two following your exam, you should contact him or her.

If your results are "normal" or "negative" This means that no abnormal cell changes were found. You should make an appointment for your next regularly scheduled Pap test. Remember to keep that appointment. Depending on the Pap test results, your doctor may recommend tests more or less often. If your results are "abnormal" or "positive" This means that your Pap test may show abnormal cell changes in your cervix. You may need to have the Pap test again. Your doctor will let you know if you need any other tests.

An "abnormal" or "positive" Pap test does not mean that you have cervical cancer. Most women with an abnormal Pap test do not have cervical cancer. But it is important that you protect your health by getting the follow-up tests and care that your doctor suggests.

Doctor Nguyen: "If someone you know does not speak English, she can ask for an interpreter when she schedules her appointment. She can also ask that the results of the test be sent in Vietnamese. Or, she can ask that an interpreter call to give her the results."

Back to Top Pap Test Tips to Remember

• Do not have a Pap test during your period (menstruation). The best time to schedule a Pap test is between 10 and 20 days after the first day of your last period.
• For about 2 days before the Pap test:
  • do not douche
  • do not put medicines or spermicidal foams, creams, or jellies inside the vagina
• Do not have sexual intercourse for 1-2 days before your Pap test. This may cause unclear results.

Doctor Nguyen: "Many women who never had sex before want to know they are still virgins after a Pap test. The Pap test can be done without affecting virginity. To lessen the discomfort, you can ask your doctor to use the smallest speculum."

Back to Top Where Do I Get a Pap Test?

• At an obstetrician's or gynecologist's office
• At a family doctor's office
• At a health clinic

Back to Top How Do I Pay for a Pap Test?

Below are ways to pay for a Pap test if you do not have health insurance.

• If you qualify for Medicaid, you may not have to pay for the doctor visit or for a Pap test. For more information, call the Medicaid Information Line in your state. Visit www.cms.hhs.gov/medicaid for an online listing.
• If you are age 65 or older, Medicare will help pay the cost of a Pap test, generally once every 2 years. For more information about Medicare coverage for Pap tests, call 1-800-MEDICARE (1-800-633-4227).
• If you have a low income or no insurance, you can go to public hospitals or clinics for Pap tests and pay based on your income. Some states provide free and low-cost Pap tests to eligible women who may not be able to afford the test on their own. For information about where to go for free or low-cost Pap tests in your area call 1-800-4-CANCER (1-800-422-6237).

Back to Top Frequently Asked Questions

Do virgins need Pap tests?
Yes. Every woman should begin to have regular Pap tests at least by the time she is 21 years old.

Do older women need Pap tests?
If you are 65 years or older, ask your doctor if you should continue to get Pap tests. Your doctor will tell you how often you should get one, based on your previous test results.

Does a woman need Pap tests after a hysterectomy?
Women who had their uterus removed because of cervical pre-cancer or other cancer may still need to get regular Pap tests. You should talk to your doctor if you are not sure about this issue.

Do women who have gone through menopause need Pap tests?
Yes, because cervical cancer can appear after menopause.

Back to Top For More Information

You can ask for more copies of this booklet, talk with a representative from the National Cancer Institute, or read brochures online.

• Toll-free phone number:
  1-800-4-CANCER (1-800-422-6237)
• TTY number: 1-800-332-8615
• Internet: www.cancer.gov

Doctor Nguyen: "Please make an appointment with your doctor for a Pap test and remember to keep that appointment. Also, remember that Pap tests must be a regular part of how you and other women in your family stay healthy for life. Get a Pap test as often as you should and follow up with your doctor every time to get your results."

Back to Top