New Option for Cervical Cancer Screening

Women over 30 have another option to be screened for cervical cancer and it allows testing less often.

According to Dr. Haley Ralph of OSF Medical Group in Kewanee, a new test screens for evidence of the cause of 90 percent of all cases cervical cancer – the human papillomavirus, or HPV. It’s recommended the test can be done alone every five years or it can be done along with a Pap smear which is required every three years.

The Pap test evaluates samples of cervical tissue for precancerous changes and it’s still the best option for catching possible cancer in women ages 21 to 29 according to new guidelines from the U.S. Preventive Services Task Force which makes evidence-based recommendations for health care providers.

Dr. Ralph, who specializes in women’s health, says for women 30-65 years old it is important to include an HPV test either alone or in combination with a Pap smear.

“You might have a normal Pap smear on the cytology, meaning there are no cellular changes but if we’re checking that to see if you have the HPV virus in your system, we might be able to do better preventative services for you … catching things earlier and doing closer monitoring,“ she explained.

So what happens when an HPV test comes up positive?

“Say you have a normal Pap smear, the cells haven’t changed but you have the DNA (for the HPV virus), then we might recommend you come back at six to 12 months. It all depends on what your results are but typically you have more frequent monitoring and more frequent exams,” said Dr. Ralph.

One approach can be to check the HPV DNA test for high-risk strains. If a high-risk strain is detected, then your doctor might recommend evaluation with colposcopy which allows a closer look at the cervix.

Dr. Ralph says if a high-risk DNA test is negative, she recommends a follow up exam in 12 months.

Women might not notice the difference between a Pap and HPV tests because tissue samples are collected the same way -- by removing a few cells from the cervix. There are more than 100 types of HPV that are passed on through sexual contact. However, there is no HPV test for men so Ralph suggests vaccination is the best cancer prevention approach for women and men.

“So it can lead to things like rectal cancer, mouth or throat cancer, penile cancer. So these can definitely have effects of them as well.”

Ralph says there is another consideration for women over 30. A Pap smear alone could lead to unnecessary biopsies which can affect fertility. She also stresses that even if a woman has received the HPV vaccine, she should still be screened for the potentially cancer-causing virus.

The Preventative Service Task Force says women over 65 do not need to be screened for cervical cancer if they are up to date on testing, have not had negative results and have no other risk factors. The U. S. Surgeon General says smoking is a risk factor for cervical cancer because certain types of HPV and cancer-causing chemicals in tobacco may work together to increase your likelihood of developing cancer.

Five Cervical Cancer Facts from the American Cancer Society

• Cervical cancer is projected to kill more than 4,100 women in 2018.
• Cervical cancer tends to occur in midlife and is most frequently diagnosed in women between the ages of 35 and 44.
• It rarely develops in women younger than 20.
• More than 15% of cases of cervical cancer are found in women over 65. However, these cancers rarely occur in women who have been getting regular screenings before they were 65. In the United States, Hispanic women are most likely to get cervical cancer, followed by African-Americans, Asians and Pacific Islanders, and whites. American Indians and Alaskan natives have the lowest risk of cervical cancer in this country.

Discuss your cervical cancer screening options with your primary care provider or gynecologist. Don’t have one? Check out OSF HealthCare providers in your area.