Basic Facts About Cervical Cancer

What Causes Cervical Cancer?

About the Pap Test

When Should I Have a Pap Test?

Where Can I Get a Pap Test?

How Do I Pay for a Pap Test?

For More Information

Cervical Cancer Can Be Prevented

Did you know that there is a simple test your doctor can do that can help prevent cervical cancer? It is called the Pap test. This test can help you stay healthy so you can be there for your family.

How a Pap test can help

• The Pap test can find early cell changes in the cervix before these changes turn into cancer.
• If the test finds cell changes early enough, it can prevent you from having cervical cancer.

Be sure to get a regular Pap test

Having a Pap test once is not enough!

• Women and teenagers should start getting regular Pap tests about 3 years after the first time they have sex.
• Women should have a Pap test no later than age 21, even if they have not started having sex.
• Women should get a Pap test at least once every 3 years.

Doctor Vargas: "Many women do not know about the Pap test. Then they find out they have cervical cancer when it is at an advanced stage. The cancer could have been prevented with regular Pap tests."

Read this booklet

This booklet can answer some questions about cervical cancer and may ease your concerns about having the Pap test.

This booklet talks about:

• Cervical cancer
• The Pap test (sometimes called a Pap smear)
• How often to get a Pap test
• Common questions and answers.

See what other women have to say

You will read about 3 women. They may be like you or other women you know. Consuelo, Rosa, and Virginia have a lot of questions about the Pap test. Read their questions and answers in this booklet.

Consuelo

Rosa

Virginia

Where is the cervix?

The picture below shows a woman's reproductive organs.

• The cervix is the lowest part of the uterus. It forms an opening between the uterus and the vagina.
• The uterus, or womb, is where the baby grows when a woman is pregnant.

How does cervical cancer start?

• Sometimes cells in a woman's cervix begin to grow in an abnormal and disorganized way.
• These abnormal cells may not be cancer yet. Without treatment, they can become cancer.
• Most of the abnormal changes in the cells of the cervix do not cause any symptoms in the beginning. That is why it is important to get a Pap test. It will help to see if there are any early changes in the cells.
• A "negative" test result means that no cell changes were found. A "positive" result means that there might be cell changes.
• If there are changes, your doctor will treat them before they turn into cancer cells. With the help of your doctor, you can prevent cervical cancer.

Consuelo: I take care of myself and I feel great. Why do I need a Pap test?

Doctor Vargas: "Although you may feel healthy, the abnormal changes that can end up as cancer can appear without any symptoms. This can happen even when you are feeling great. That is why it is important to get regular Pap tests."

The main cause for cervical cancer is a virus. It is called HPV. This stands for human papillomavirus (pronounced pap-ih-LO-ma-VYE-rus).

HPV: A common virus in women and men

• HPV is a virus spread through sexual contact.
• You can be infected with HPV and not know it. You will not feel the virus or see it. Usually there are no symptoms.
• Most HPV infections go away on their own. But some may not. The infections that do not go away can lead to cell changes in the cervix. These cell changes can lead to cervical cancer.
• The Pap test can often find changes caused by HPV before they lead to cervical cancer.

Doctor Vargas: "Some women wonder if they can get HPV through forms of intimate contact other than vaginal sex. The answer is yes. HPV can be spread through vaginal and anal intercourse; finger to genital contact; and finger to anal contact."

Getting tested for HPV

Rosa: I have only had sex with one person. Do I have to get a Pap test?

Doctor Vargas: Yes. Women should get regular Pap tests even if they have had only one partner. HPV is a very common virus. Someone could have it and not know it.

• The Pap test is simple, fast, and routine.
• The Pap test is the best way to find abnormal cell changes in the cervix. It can find them early, before they turn into cancer.
• The Pap test is normally done at the same time as a pelvic exam.

• The Pap test does not check for HPV. It only checks for cell changes that could become cancer.
• The Pap test does not cause cancer. It also does not prevent pregnancy.
• The Pap test does not detect sexually transmitted diseases (STDs). Ask your doctor if you want tests for these.

During the Pap test

• Either a female doctor or female nurse will be with you during the test. For your comfort, your legs will be covered with a sheet.
• Your doctor will take cells from the cervix. Your doctor will use a clean instrument called a "speculum" to see the cervix. Your doctor will use a swab or a small brush to get some cells.

Doctor Vargas: "It is normal to feel nervous. But it is helpful to try to relax as much as possible. You might feel slight discomfort, pressure, or have light bleeding. If you feel uncomfortable, tell the doctor immediately."

After the Pap test

• Your doctor sends the cells to the lab.
• The results come back to your doctor in 1 or 2 weeks.
• If the test results are normal ("negative"), they may not notify you at all. In that case, you should call to be sure that the results are normal.
• If there is something abnormal on the test ("positive"), your doctor should tell you. Then, you should return to see your doctor.
• Most times, an abnormal ("positive") test does not mean that you have cancer. It only means that your doctor needs to do more tests.

Virginia: After a Pap test, is a woman still a virgin?

Nurse Vivian: "Many women who have not had sex yet want to know if they are still virgins after having 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."

A few things to remember:

• A Pap test does not cause cancer, does not prevent pregnancy and does not test for STDs.
• Some products may wash away or hide abnormal cells. Unless instructed by your doctor, for 2 days before a Pap test, do not:
  • Douche
  • Use any vaginal medicines
  • Put spermicidal foams, creams, or jellies in your vagina.
• Do not have sexual intercourse for 1 to 2 days before your Pap test. This may cause unclear results.
• After the test, you can go back to your normal activities and return to work right away.
• If you get your period on the day of the test, call your doctor right away to make another appointment. Make the appointment for when you are not having your period.

Rosa: I often feel embarrassed to talk about my body and other private issues.

Nurse Vivian: "Because of our culture, we are not used to talking about sex and intimate parts of the body. But remember, your doctor is used to discussing these sensitive issues every day and wants to help you. Even if you feel embarrassed, remember that this test is important for your health."

When should I start?

• About 3 years after beginning to have sex
• No later than age 21, even if you are not having sex.

How often?

• At least once every 3 years. Depending on the results, your doctor may suggest getting tested more often than that.

When should I stop?

• If you are 65 years old or older, talk to your doctor about whether or not you should keep having Pap tests. Your doctor will tell you how often you should get one. This will depend on the results of your previous tests.
• If you had a "total hysterectomy" (pronounced hiss-ter- EK-toe-mee), you do not need a Pap test. However, you should have the Pap test if the surgery was done to treat pre-cancer.

Consuelo: My husband died 15 years ago. Do I still have to get a Pap test?

Doctor Vargas: "Yes, because you can have cervical cancer even if you are not currently having sex."

Consuelo: I am a grandmother. I do not get my period anymore. Do I have to get a Pap test anyway?

Nurse Vivian: "Yes, because cervical cancer can appear after menopause."

• Doctor's office
• Clinic or community health center
• Your local health department.

• Free and low-cost tests: If you do not have health insurance, there may be places in your community where you can get a Pap test for free. People with a low income or without health insurance may be able to go to a clinic to have the test done. For more information on where to get a free or low-cost Pap test, call toll-free 1-800-4-CANCER (1-800-422-6237). It is possible to speak to a representative in English or Spanish.
• Insurance coverage: If you have health insurance, it will usually pay for the Pap test. Some companies have their own rules regarding the test. If you have questions about coverage, talk to your insurance company.
• Medicaid: If you are eligible for Medicaid, you might not have to pay for the doctor visit and the Pap test. For more information, call the nearest Medicaid office.
• Medicare: If you are 65 years of age or older, Medicare pays for the Pap test every 2 years, or every year for certain women at higher risk. For more information about coverage for the Pap test by Medicare, call toll-free 1-800-MEDICARE (1-800-633-4227). It is possible to speak to a representative in English or Spanish.

It is easy to get free information about cervical cancer or other types of cancer.

• By phone: Call toll-free 1-800-4-CANCER (1-800-422-6237)
  There are instructions to hear information in English or Spanish. You can also talk with a representative in English or Spanish.
• On the Internet: Visit www.cancer.gov
  Information is available to read or print in English or Spanish (click on "Español").