Can You Get Checked for Cervical Cancer Before You Have Symptoms?

Screening tests check for signs of cancer in people who don’t have any symptoms. Screening for cervical cancer has been very successful. That’s why experts recommend mass screening for cervical cancer.

You have a better chance of surviving cervical cancer if your doctor finds and treats it early. The best way to find cervical cancer early is to have a regular Pap test.

A Pap test is used to remove a few cells from your cervix to see if there are any cell changes that are cause for concern. A pathologist looks at the removed cells under a microscope to see if there are any cells that are abnormal.

How Often You Need to Be Screened

You should have a Pap test once a year. Your doctor may say it’s OK to do the test every two years if he or she uses a newer Pap test called a liquid-based test. Studies show the new liquid-based test is more successful at finding precancerous cells. But it is usually more expensive.

If any of these cases applies to you, you may not need to get yearly Pap tests.

• You’re older than age 30 and have had three normal Pap tests in a row. If so, you may only need the test every two to three years.

• You’ve had your cervix surgically removed for reasons that were not cancer-related. If so, you may not need the test.

• You are older than age 70, and you’ve had at least three normal Pap tests in a row in the last 10 years. If so, you may choose not to get them anymore.

It’s best to talk with your doctor about a Pap test schedule that takes into account your personal risk factors. There are some cases where women are likely to need Pap tests more often. For instance, you may need a test more often if you have HIV or if you have had positive results for a Pap test in the past.

Before the Pap Test

You should avoid these things before your Pap test.

• Do not douche for at least two days (48 hours).

• Do not have sex for two days (48 hours).

• Do not use a tampon for two days (48 hours).

• Do not use any kind of vaginal products or medicines for two days (48 hours).

Ask when you can expect results and how you will receive them. For instance, will you receive results by telephone or in the mail? Knowing how long you will have to wait for results may help you feel less anxious.

Medical examination with speculum and Pap test brush (spatula).

How the Pap Test Is Done

The Pap test is simple and relatively painless. You can have it right in the doctor’s office. You should not have this test during your period. The best time to have a Pap test is 10 to 20 days after the first day of your last period.

A Pap test may feel uncomfortable, but it should not hurt, and it takes just seconds. The doctor uses a tool called a speculum to widen your vagina and examine the upper part of your vagina and cervix, which is the area that connects your vagina to your uterus. The doctor then uses a small, soft brush to collect cells from your cervix and vagina. A specialized doctor called a pathologist looks at the cells at under a microscope to check for cancer.

There are two types of Pap test. The difference between the two has to do with how the cells are checked after they are taken from your cervix. There is not a difference in how the cells are removed from you.

• With the regular method, the healthcare provider puts the cell sample on a slide and a pathologist checks it in a lab.

• With the newer, liquid-based test, the doctor mixes a special liquid with the cells. This helps to preserve the cells for testing so that they can be seen and checked more clearly in the lab.

Some laboratories may use computerized instruments that can spot abnormal cells in Pap tests. The AutoPap instrument has been approved by the US Food and Drug Administration (FDA) for retesting Pap test samples that were interpreted as normal by technologists. It is also approved by the FDA for initial testing of Pap tests, instead of testing by a technologist. But a technologist would still look at all Pap smears that the AutoPap identified as abnormal. It is thought that these computerized instruments can find abnormal cells that are sometimes missed by technologists. Scientists do not yet know whether the instrument can find enough high-grade abnormalities missed by human testing to have a significant impact on preventing invasive cervical cancers. Automated testing also increases the cost of the cervical cytology testing.

If your Pap test gives a positive result, it means that abnormal cells may be present. In that case, your doctor may order a human papillomavirus (HPV) test. This test looks at the abnormal cells to see if high-risk HPV is present. The Food and Drug Administration (FDA) has approved the use of the HPV test along with the regular Pap test for women over age 30. This simply means that rather than doing the HPV as a follow-up test, your doctor can do the Pap and HPV test at the same time. The combined test is not used for women under 30 years old because cervical cancer is very rare in this age group. In most women under 30 who have HPV, the virus will go away before it causes any cell changes or symptoms.

HPV has been shown to cause almost all types of cervical cancer. Now that doctors can test for its presence, it is possible to know which women are at risk of developing cervical cancer and which women have little or no risk of developing cervical disease or cervical cancer in the near future.