A simple explanation of pap smears and HPV testing
More than 13,000 US women are diagnosed with cervical cancer each year. In most cases, this disease is preventable through vaccination and proper screening.
Despite screening programs, 4,000 US women die from HPV related cervical cancer annually.
What is the point of a pap smear?
A pap (Papanicolaou) smear is a screening test for cervical cancer. The cervix is the opening of the uterus located at the back of the vagina. During a pap smear, doctors place a device called a speculum into the vagina. This allows the walls of the vagina to be spread apart allowing visualization of the cervix. Cervical cells are then collected using a small brush. These cells are sent to a lab for analysis. The cells are processed under a microscope to evaluate for precancerous changes called cervical dysplasia. The goal of pap screening is to detect abnormal cervical changes so we can intervene long before cervical cancer develops.
Why did the doctor do an HPV test with my pap?
In addition to analyzing the cervical cells, doctors often perform an HPV test. This depends on your age. HPV testing is recommended for standard screening in women over 30. HPV testing is also triggered when an abnormal pap smear is found in women under 30. Cervical dysplasia (precancerous cells of the cervix) are linked to the Human papillomavirus (HPV). Statistically, 80% of Americans will contract HPV, making it the most common sexually transmitted infection. This means more of us will contract this STI than those who do not. HPV “co-testing” during pap smear helps guide the management steps when an abnormality occurs.
Around 40 of the known 130 known strains of HPV affect the genital tract. In men and women, HPV causes genital warts, and persistent strains can lead to cervical, penile, vaginal, anal, mouth, throat, and neck cancer. Approximately 20,000 women and 12,000 men develop cancer caused by HPV every year in the United States.
Who is at risk for HPV?
Anyone sexually active is at risk. The virus may stay dormant for years. Symptoms may not appear until long after you have sex with someone previously infected. It is rarely possible to know when you first became infected. You can not play the blame game with HPV. The HPV vaccine and keeping your pap smears up to date are our best tools to impact cervical disease and HPV.
There is no cure or medication for HPV. The most effective way to protect yourself from HPV infection is to get vaccinated. The HPV vaccine is FDA approved for men and women age 9–45. The Center for Disease Control recommends that the vaccine be given as early as 11 or 12. The vaccine is most effective when given before initiating sexual activity. It is still useful for those already sexually active as very few have already been exposed to the nine strains of HPV covered in the vaccine. The most recent recommendations extended the age from 26 to 45, but insurance coverage for those in this age group is lagging.
A few minutes of discomfort can save your life
Pap smears save lives. Period. No-one likes to get this test, but the benefits of early detection and prevention outweigh the risks of avoiding it.
By: Dr. Jeff Livingston