Earlier this year, experts concluded that most women don’t need annual pelvic exams, but they also confirmed that regular Pap tests are still necessary to screen for cervical cancer. The Centers for Disease Control and Prevention, however, recently concluded that millions of women are not getting this test.
According to the CDC, 8 million women 21 to 65 years old haven’t been screened for cervical cancer in the last five years. Like all life-threatening cancers, early detection is the best way to prevent or treat cervical cancer.
Every year, more than 12,000 U.S. women are diagnosed with cervical cancer, and for more than 4,000, it’s fatal. According to the CDC, more than half of women diagnosed with cervical cancer have never or seldom been screened.
A Pap test screens for abnormal cells that may develop into cancer. The test is not painful, and consists of a doctor scraping cells from the cervix for analysis by a lab. Generally, vaginal cells also are tested for the presence of the human papillomavirus (HPV), which causes most cervical cancers.
If abnormal cells are found, they can be removed before developing into cancer.
Because of its proven ability to prevent transmission of the virus, the HPV vaccine is recommended for middle-school boys and girls, before they become sexually active. Although boys, of course, can’t get cervical cancer, they can transmit the virus to their sexual partners.
Unfortunately, as we’ve blogged, the vaccine isn’t being given to everyone who should have it. Only 1 in 3 girls and 1 in 7 boys have finished the three-dose series that can protect against not only cervical cancer, but cancers of the penis, anus, mouth and throat.
Regular cervical cancer and HPV screening for women is simple and affordable – the Affordable Care Act (“Obamacare”) requires that health insurers provide all cancer screenings at no charge to the patient.
As explained by NBC News, CDC experts reviewed national surveys from 2012, and found that more than 11 in 100 women reported that they had not been screened for cervical cancer in the past five years, often because of a lack of health insurance: Nearly 1 in 4 women without health insurance and 1 in 4 without a regular doctor or other health-care provider said they hadn’t had a screening.
Lack of screening doesn’t just reflect lack of money. Dr. David Fishman, an expert on women’s cancers, told NBC that “Women who should be having Pap smears are not getting plugged in, and this is a significant problem in our country. The Pap smear, in my opinion, is the most powerful tool in the history of medicine to detect precancerous change such that no woman should ever die from cervical cancer.”
Annual cervical cancer screening isn’t necessary: The United States Preventive Services Task Force (USPSTF) and the American Cancer Society recommend that women 21 to 65 get either a Pap smear or a test for HPV every three years. Some experts believe that women older than 65 who have had three “clear” screens in a row needn’t be screened again, but others believe that’s too young to stop screening. A study this year suggested that women older than 65 might have a higher risk of cervical cancer.
Bottom line: if you’re female, get a Pap test and/or an HPV screen at least every three years, and more frequently if you’ve had a positive result in the past.
To understand what’s involved in the standard, but outdated pelvic exam, and why it’s different from a Pap test, see our blog.