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Cervical cancer screening references
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Each year, about 13,000 women develop cervical cancer in the US, with approximately 4,000 women dying from the disease. The number of cervical cancer cases has dramatically decreased since the introduction of widespread screening by a vaginal smear test commonly known as the "Pap smear." Cervical cancer usually grows slowly over many years. Before true cancer cells develop, the tissues of the cervix undergo changes -- called dysplasia, or precancerous changes -- that a pathologist can detect on a Pap smear. If left untreated, these changes have the tendency to grow into the surrounding tissue and become cancerous.

Cervical cancer and its precursors usually occur among women who are sexually active. The most important risk factor for cervical cancer is genital infection with the human papilloma virus (HPV), which is usually acquired during sexual activity. Using HPV detection techniques, it appears that DNA from these viruses is found in virtually all cervical squamous cell carcinomas (the most common type of cervical cancer). Like other gynecologic cancers, detection of cervical cancer in its earliest stages is essential and can be lifesaving.

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Cervical Cancer Screening Tests

A Pap test or a liquid-based cervical cytology test (i.e. ThinPrep® or SurePath®) is used to detect the possibility of a cervical cancer or dysplasia. Liquid-based screening may have improved sensitivity when compared with the conventional Pap test but it has a higher cost. Liquid-based tests also can test for the presence of HPV, which can prove especially useful for women whose Pap results come back positive. The role and usefulness of HPV testing as an alternative or additional test to primary Pap screening continues to evolve. (Note that many abnormal Pap screening test results signify the presence of a precancerous condition that either resolves itself without treatment or can be treated before it becomes cancerous.)

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Our Cervical Cancer Screening Guidelines

First Screening

Our doctors recommend that women have their first cervical cancer screening about three years after their first sexual intercourse or by the age of 18 -- whichever comes first.

Women Up to Age 30

For women up to the age of 30 years old, our doctors recommend annual cervical cytology testing (which can include Pap smears or liquid-based cytology).

Women 30 Years and Older

For women 30 years old and older, our doctors recommend one of the following three screening options:

  • Annual cervical cytology testing (which can include Pap smears or liquid-based cytology)
  • Women who have had three negative or satisfactory annual cytology tests may be screened with cytology every two to three years.
  • Cytology plus HPV-DNA test. If both the cytology and the DNA tests are negative, screening should occur every three years.

Immunocompromised Women of Any Age

In addition, any women of any age who are immunocompromised (as the result of organ transplantation, HIV infection, or cancer chemotherapy) and treated with steroids, or who were exposed in utero to an estrogen drug known as diethylstilbestrol (DES), should be screened annually with either Pap smear or liquid-based cytology. [From 1938 to 1971, DES was prescribed to some pregnant women to prevent miscarriage. The female children of these women have an increased risk of a rare cervical and vaginal cancer.]


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Last Updated: Apr. 21, 2006
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