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Getting abnormal results does not mean that you have cervical cancer now. For specific questions about your test results, talk to your doctor. Click hyperlinked words to view their definitions.
What is cervical cancer?
Cancer can grow on a woman’s cervix—the same way it can grow on other body parts. Most times, cervical cancer forms
slowly. Cervical cancer often
does not cause symptoms until
it is advanced. When cervical
cancer is advanced, it may
cause abnormal bleeding,
discharge, or pain.
The cervix is the opening of your uterus (womb). It is part of a woman's reproductive system.
What causes cervical
cancer?
A virus, called genital human
papillomavirus (pap-ah-LOmah-
VYE-rus)—also just called
HPV—can cause normal cells
on your cervix to turn abnormal.
Over many years, abnormal
cells can turn into cancer if
they are not found and treated
by your doctor. It can take
10 to 15 years (or more) for
cells to change from normal to
abnormal, and then into cancer.
Abnormal cells are sometimes
called “pre-cancer” because
they are not normal, but they
are not yet cancer.
You cannot see or feel HPV or
these cell changes on your cervix.
What is cervical cancer
screening?
Screening tests can find early
problems before you get sick.
The Pap test is a screening test
for cervical cancer. It looks for
abnormal cells on your cervix that could
turn into cancer over time. That way, problems can
be found and treated before
they ever turn into cancer. An
HPV test may also be used with
the Pap test.
If you’re reading this booklet,
you have taken the first step
to prevent cervical cancer by
getting screened.
Every year in the United States, about 10,000 women get
cervical cancer. But it is the most preventable female cancer
with regular screening tests and early treatment.
What is HPV?
HPV is a common virus. There are
about 40 types of HPV that can
infect the genitals or sex organs
of men and women. HPV is so
common that most people get
it at some time in their lives. But
HPV usually causes no symptoms
so you can’t tell that you have it.
What can HPV do to
my body?
HPV can infect the genital areas
in different ways:
Some HPV types can cause
changes on a woman’s cervix
that can lead to cervical cancer
over time.
Other HPV types can cause
genital warts in men and
women.* But the HPV types
that can cause genital warts
are different from the types that
can cause cervical cancer.
Most of the time, HPV goes away
by itself within two years and
does not cause health problems.
It is thought that the immune
system fights off HPV naturally.
Experts do not know why HPV
goes away in most, but not all
cases. It is only when HPV stays
on a woman’s cervix for many
years that it can cause cervical
cancer.
How could I get HPV?
HPV is passed on through
genital (skin to skin) contact,
most often during vaginal or
anal sex. Most people never
even know they have HPV,
or that they are passing it to
their partner. So it may not be
possible to know who gave you
HPV or when you got it. HPV is
so common that most people
get it soon after they start
having sex. And it may only be
found years later.
All women who ever had sex are at risk for HPV and cervical cancer.
HPV is NOT the same as HIV (the AIDS virus) or herpes.
All of these viruses can be passed on during sex. But they do not cause the
same symptoms or health problems.
You can prevent cervical cancer with regular screening tests, like the
Pap test. An HPV test can also be used with the Pap test. These
tests are often done at the same time.
Since cervical cancer often does not
cause symptoms until it is advanced, it is important to get screened even when
you feel healthy.
The Pap and HPV tests look for different things:
The Pap Test
Checks your cervix for abnormal cells that could turn into cervical cancer.
The HPV
Test
Checks your cervix for the
virus (HPV) that can cause abnormal cells and cervical cancer.
The Pap and HPV tests can find early problems that could lead
to cervical cancer over time. These tests do NOT:
Check for early signs of other cancers
Check your fertility (ability to get pregnant)
Check for all HPV types – There are many types of HPV. The HPV
test only checks for specific HPV types that are linked to cervical
cancer
Check for other sexually transmitted infections (STIs).
Do experts recommend getting the HPV test with the Pap test?
The HPV test is not recommended by all expert organizations. But
some organizations do recommend it for certain women if:
You don’t need to ask your doctor for an HPV test. Your doctor
should offer you an HPV test if you need it and it is available in
their practice.
Why is the HPV test NOT recommended for younger women
and teens?
HPV is very common in women under age 30. But it is not useful to
test young women for HPV, since most HPV that is found in these
women will never cause them health problems. Most young women
will fight off HPV within a few years.
HPV is less common in women over the age of 30. HPV is also
more likely to signal a health problem for these women, who may
have had the virus for many years. Doctors may use the HPV test
to tell if these women are more likely to get cervical cancer in the
future, and if they need to be screened more often.
Getting regular Pap tests, even without the HPV test, is still a good
way to prevent cervical cancer—for both younger and older women.
What Does My Pap Test Result Mean?
Your Pap test will come back as either “normal,” “unclear,” or “abnormal.”
Normal
A normal
(or “negative”) result means that no cell changes were found on
your cervix. This is good news. But you still need to get Pap tests in the
future. New cell changes can still form on your cervix.
Unclear
It is common for test results to come back unclear. Your doctor may use other words to describe this result, like: equivocal, inconclusive, or ASC-US. These all mean the same thing: that your cervical cells look like they could be abnormal. It is not clear if it’s related to HPV. It could be related to life changes like pregnancy, menopause, or an infection. The HPV test can help find out if your cell changes are related to HPV.
Abnormal
An abnormal result means that cell changes were found on your cervix. This usually does not mean that you have cervical cancer.
Abnormal changes on your cervix are likely caused by HPV. The changes may
be minor (low-grade) or serious (high-grade). Most of the time, minor changes
go back to normal on their own. But more serious changes can turn into cancer
if they are
not removed. The more serious changes are often called “precancer”
because they are not yet cancer, but they can turn into
cancer over time. It is important to make sure these changes do not get worse.
In rare cases, an abnormal Pap test can show that you may have cancer.
You will need other tests to be sure. The earlier you find cervical cancer,
the easier it is to treat.
If your Pap test results are unclear or abnormal, you will likely need
more tests so your doctor can tell if your cell changes could be
related to cancer.
Making Sense of Your Pap and HPV Test Results
“I see my doctor each year for a Pap test. This year, my doctor told me the test was abnormal. He also said I have HPV. I was confused. What does this mean?”
It can be confusing to get your Pap and HPV test results at the same time.
Your HPV test will come back as either “positive” or “negative”:
A negative HPV test means you do not have an HPV type that is linked to cervical cancer.
A positive HPV test means you do have an HPV type that may be linked to cervical cancer. This does not mean you have cervical cancer now. But it could be a warning.
HPV test results are only meaningful WITH your Pap test results. To understand
what these tests mean together:
If your HPV Test is Negative (normal), and your Pap test is:
Normal
This means:
you do not have HPV
your cervical cells are normal
you have a very low chance of getting cervical cancer in the next
few years.
You should:
wait three years before getting your next Pap and HPV test
ask your doctor when to come in for your next visit.
Experts used to suggest yearly Pap tests. But now you can wait longer
because having the HPV test with your Pap test gives you extra peace
of mind.
Unclear
This means:
you do not have HPV, but your Pap test was unclear
even if you do have cell changes, it is unlikely that they are caused
by HPV (or related to cervical cancer).
You should:
get another Pap test in a year just to be sure. You may also get
an HPV test at that time.
Abnormal
This means:
your Pap test found abnormal cells
your HPV test did not find HPV.
It’s important to find out why the two tests are showing different
things.
For minor cell changes, your doctor will:
take a closer look at your cervix to decide next steps.
For major cell changes, your doctor will:
take a closer look at your cervix and/or treat you right away.
If
your HPV Test is Positive (abnormal), and your Pap test is:
Normal
This means:
your cervical cells are normal, but you have HPV.
You may fight off HPV naturally and never get cell changes. Or, you
may not fight off HPV, and HPV could cause cell changes in the future.
Most women fight off HPV within two years. It is not known why some
women fight off HPV and others do not.
You should:
get another Pap test and HPV test in a year.
Cell changes happen slowly. Some time must pass before your doctor
can tell if HPV will go away or cause cell changes.
Unclear
This means:
you have HPV, but your Pap test was unclear.
You doctor will:
take a closer look at your cervix to find out if your cells are
abnormal.
Your doctor may need to remove the abnormal cells or follow up with
you over time to make sure the cells do not get worse.
Abnormal
This means:
you have HPV
your cervical cells are abnormal
This does not usually mean you have cancer.
For minor cell changes, your doctor will:
take a closer look at your cervix to decide next steps.
For major cell changes, your doctor will:
take a closer look at your cervix and/or treat you right away.
If I have HPV, do I have cervical cancer?
No, HPV is not the same as
cervical cancer. HPV is the virus
that can cause cervical cancer.
Many women have HPV. Few of
them get cervical cancer if they
follow their doctor’s advice for
more testing and/or treatment.
What will happen if I need to
come back for more testing?
Your doctor will do what’s right
for you, based on your test
results. Your doctor may:
Ask you to wait before
re-doing the Pap and/or HPV
test. This is called “watchful
waiting.” It is common.
Take a closer look at your
cervix. This is done using a
special lens that makes your
cervical cells look bigger
(called a colposcopy).
Take a small sample of your
cervix (biopsy) to study it
more carefully.
Treat you. This involves killing
or taking out the abnormal
cells. These treatments may
be uncomfortable, but they
can be done during one visit
to your doctor.
Refer you to a specialist. This
might happen if your test
results suggest that you may
have cancer.
Why wait for more tests if I
could have cancer?
It is possible that your cell
changes will never turn into
cancer. They may go back
to normal on their own. But
cervical cells change very
slowly. Some time must pass
before your doctor can tell
if your cells need treatment.
Since treatment can have risks
and side effects, it is best to
make sure you really need it.
Be patient. Go back to your
doctor for all appointments and
testing—to make sure your cell
changes do not get worse.
Remember: Many women
get HPV or abnormal Pap
tests. But few of them get
cervical cancer—as long
as they get the tests and
treatments their doctor
recommends. Most times,
problems that are found
can be treated before they
ever turn into cervical
cancer.
What else can I do to prevent
cervical cancer?
Keep your next doctor’s
appointment. Mark your
calendar or post a note on your
fridge, so you remember it.
Go back for more testing or
treatment if your doctor tells
you to.
Keep getting regular Pap
tests—at least once every
three years.
Do not smoke. Smoking
harms all of your body’s cells,
including your cervical cells.
If you smoke and have HPV,
you have higher chances of
getting cervical cancer. If you
smoke, ask your doctor for
help quitting.
Questions To Ask Your Doctor
Be sure to ask your doctor about anything you don’t understand.
How do I talk to my partner about HPV?
You and your partner may benefit from talking openly about HPV. You can tell your partner that:
HPV is very common. It can infect the genital areas of both men and women. It usually has no signs or symptoms and goes away on its own.
Most sexually active people get HPV at some time in their lives, though most will never know it. Even people with only one lifetime sex partner can get HPV, if their partner
had it.
There is no test yet for men to find out if they have HPV. But the most common health
problem caused by HPV in men is genital warts. The type of HPV found on your HPV test can cause cervical cancer in women; it does not cause genital warts.
Partners who have been together for a while tend to share HPV. This means that your partner likely has HPV already, even though your partner may have no signs or symptoms.
Having HPV does not mean that you or your partner is having sex outside of your relationship. There is no sure way to know when you got HPV or who gave it to you. A person can have HPV for many years before it is found.
If your sex partner is female, you should talk to her about the link between HPV and cervical cancer, and encourage her to get a Pap test to screen for cervical cancer.
Common Questions about HPV
Is there a treatment for HPV or abnormal cells?
There is no treatment for HPV (a virus). But there are treatments for abnormal cervical cells, which can be killed or removed. Treating abnormal cells will stop them from growing into cancer. But it may not remove the virus (HPV). That’s why it’s
important to go back to your doctor as told, to make sure abnormal cells
do not grow back. You may need to get Pap tests more often for a while. But
most people do eventually fight the
virus off.
Does having HPV or abnormal
cervical cells affect my
chances of getting pregnant
or having healthy babies?
Having HPV or cell changes on
your cervix does not make it
harder to get or stay pregnant.
The type of HPV that is linked
to cancer should not affect the
health of your future babies.
But if you need treatment for
your cell changes, the treatment
could affect your chance of
having babies, in rare cases.
If you need treatment, ask
your doctor if the treatment
can affect your ability to get
pregnant or have a normal
delivery.
Will I pass HPV to my current
partner?
If you have been with your
partner for a while, your partner
likely has HPV too. But your
partner likely has no signs or
symptoms of HPV. Partners
usually share HPV, until your
bodies fight it off naturally.
There is no way to know if your
partner gave you HPV, or if you
gave HPV to your partner.
Can I prevent passing HPV to
a new partner?
Condoms may lower your
chances of passing HPV to your
new partner, if used all the time
and the right way. But HPV can
infect areas that are not covered
by a condom—so condoms
may not fully protect against
HPV. The only sure way to
prevent passing HPV to a new
partner is to not have sex.
Can my male partner get
tested for HPV?
Right now, there is no HPV test
for men. HPV is just as common
in men as in women, but it is
easier to find in women. The
types of HPV that put you at risk
for cervical cancer rarely cause
health problems for most men.
I heard about an HPV vaccine.
Can it help me?
An HPV vaccine is now
recommended for 11-12
year-old girls. It is also
recommended for women up
to age 26 if they did not get
the vaccine when they were
younger. The vaccine protects
against the HPV types that
cause most cervical cancers
and genital warts. But it does
not treat existing HPV, cervical
cell changes, or genital warts. It
will be most effective in females
who have not yet had sex since
they are unlikely to have HPV.
The vaccine has recently been
tested with women older than
26 years. It may one day be
available to these women, if it is
found to be safe and effective
for them. Even women who
got the vaccine when they were
younger need regular cervical
cancer screening because
the vaccine does not protect
against all cervical cancers.
If I’ve had a hysterectomy, do
I still need to get screened for
cervical cancer?
This depends on why you got
your hysterectomy, and if you
still have your cervix. If you got
a total hysterectomy for reasons
other than cancer, you may not
need cervical cancer screening.
Talk to your doctor to find out if
you still need to get screened.
Free or Low-Cost Cervical Cancer
Screening and Follow-up Tests
You may be able to get cervical cancer screening and followup
tests for free or at low cost if you:
have health insurance. If you have questions about coverage,
talk to your insurance company.
are eligible for Medicaid. To learn more, call 1-800-MEDICARE
(1-800-633-4227). You can also find your nearest Medicaid
office by visiting the U.S. Center for Medicare and Medicaid
Services at www.cms.hhs.gov/RegionalOffices/
are age 65 or older. Medicare pays for the Pap test every 2
years, or every year for some women. To learn more about Medicare’s Pap test coverage, call 1-800-MEDICARE (1-800-
633-4227). The call is free and you can speak to someone in
English or Spanish.
have a low income or do not have health insurance.
To find out if you
can get free or low-cost tests and where to
go, call or visit:
CDC’s National Breast and Cervical Cancer Early Detection
Program
To find local or state programs:
Call 1-888-842-6355 (choose option 7) Find a Local
Program
National Cancer Institute (NCI)
To find out where else you can get free or low-cost screening
and follow-up care, call 1-800-4-CANCER (1-800-422-6237).
1-800-332-9615 (TTY).
Association of Reproductive Health Professionals (ARHP)
(202) 466-3825 www.arhp.org
GLOSSARY
Abnormal Pap test (ab-NOR-mal): A finding that is not normal.
An abnormal result means that your cervix has cell changes. Your
doctor may use medical terms to describe these results. You may
hear that your result came back as “LSIL” or “HSIL”.
LSIL stands
for “low-grade squamous intra-epithelial lesions”— which
means
minor cell changes on the cervix. HSIL stands for “high-grade
squamous intra-epithelial lesions”— which means more serious
cell changes. Abnormal results do not mean you have cervical
cancer. But you need to follow up as told by your doctor.
ASC-US (ASK-us): This word stands for “Atypical Squamous
Cells of Undetermined Significance.” Doctors may use this word to
describe a Pap test result that is unclear. Your doctor may also use
words like “equivocal” or “inconclusive” to describe
this result (see
below).
Biopsy (BUY-op-SEE): Your doctor uses this test to study
abnormal cells. A small piece of tissue is taken from your cervix
and checked under a microscope.
Cancer (KAN-ser): A disease that starts when cells in the body
turn abnormal and begin to grow out of control. Abnormal cells
begin in one part of the body and can spread to other body parts.
When they spread, the damaged cells replace normal cells. There
are many types of cancer. Cancers are named based on where the
abnormal cells first started growing. Cervical cancer is when the
abnormal cells begin in the cervix.
Cells: The basic unit that makes up all living things.
Cervix (SUR-viks): The part of the womb (or uterus) that opens to
the vagina.
Colposcopy (kol-POS-coe-pee): A method your doctor can use to
magnify the cervix to see any abnormal cells.
Equivocal (ee-QUIV-o-kal): A Pap test result that is unclear. Your
doctor may also use the term “ASC-US” to describe this result.
Follow-up: Going back to see your doctor for more testing or
treatment.
Genitals (JEN-i-tlz): The reproductive organs, especially the external
sex organs.
HPV or human papillomavirus (pap-ah-LO-mah-VYE-rus): A very
common virus that infects the skin cells. There are many types of
HPV. About 40 types, called genital HPV, affect the genital areas of
men and women. Some of these types can cause cervical cancer in
women. Other types can cause genital warts in men and women.
HPV test: A DNA test that looks for HPV on a woman’s cervix.
Doctors take DNA cells by swabbing the cervix. This is often done at
the same time as a Pap test.
Inconclusive (in-kuh n-kloo-siv): A Pap test result that is unclear.
Your doctor may also use the term “ASC-US” to describe this result.
Pap test: Screening test that looks for early signs of cervical cancer.
It finds abnormal cells on a woman’s cervix. For this test, your
doctor takes cells from your cervix so that they can be looked at
with a microscope. The Pap test is often done at the same time as a
pelvic exam (see below).
Pelvic exam (PEL-vik ex-am): Exam to check the female
reproductive organs. This exam is part of a woman’s routine health
care visit. Your doctor will look at the outside of your genitals, or
sex organs, to look for problems. Your doctor will also look at and
feel your internal organs—such as your vagina, cervix, ovaries, and
womb.
Prevent: Avoid or stop from getting.
Pre-cancer: Cell changes that are not normal, but have not yet
turned into cancer.
Screening test: Getting tested for early signs of disease so the
problem can be treated before the disease ever develops. Cancer
screening tests look for early signs of cancer so you can take steps
to avoid ever getting cancer. The Pap and HPV tests screen for
early signs of cervical cancer.
Uterus (YOO-tuh-rus): The uterus, or womb, holds a growing baby
and helps push the baby out during labor.
Virus (VYE-rus): Something that lives in the body and can cause
infections. Viruses are so small that they cannot even be seen with a regular
microscope.
KNOW THE FACTS
Cervical cancer is caused by a common virus called
HPV. Anyone who ever had sex can get HPV.
Cervical cancer can be prevented with regular
screening tests and follow-up care.
The Pap test—either alone or with the HPV test—is
the best way to find early signs of cervical cancer.
If you get an abnormal test result, be sure to follow
up as told by your doctor.
Most women who get abnormal Pap test results or
who have HPV do not get cervical cancer—as long
as they follow their doctor’s advice for more tests or
treatment.
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