Cervical Cancer Screening and Prevention
Cervical cancer starts in the cells lining the cervix, the lower part of the uterus (womb). The cervix connects the body of the uterus (the upper part where a fetus grows) to the vagina (birth canal). The American Cancer Society's estimates for cervical cancer in the United States for 2023 are:
- About 13,960 new cases of invasive cervical cancer will be diagnosed.
- About 4,310 women will die from cervical cancer.
It is recommended that individuals with a cervix follow these guidelines to help find cervical cancer early. Following these guidelines can also find pre-cancers, which can be treated to keep cervical cancer from starting. These guidelines do not apply to people who have been diagnosed with cervical cancer or cervical pre-cancer. These women should have follow-up testing and cervical cancer screening as recommended by their health care team.
- Cervical cancer testing (screening) should begin at age 25.
- Those aged 25 to 65 should have a primary HPV test every 5 years. If primary HPV testing is not available, screening may be done with either a co-test that combines an HPV test with a Papanicolaou (Pap) test every 5 years or a Pap test alone every 3 years.
- Those over age 65 who have had regular screening in the past 10 years with normal results and no history of CIN2 or more serious diagnosis within the past 25 years should stop cervical cancer screening. Once stopped, it should not be started again.
- People who have had a total hysterectomy (removal of the uterus and cervix) should stop screening (such as Pap tests and HPV tests), unless the hysterectomy was done as a treatment for cervical cancer or serious pre-cancer. People who have had a hysterectomy without removal of the cervix (called a supra-cervical hysterectomy) should continue cervical cancer screening according to the guidelines above.
- People who have been vaccinated against HPV should still follow these guidelines for their age groups.
To request a screening for cervical cancer, speak with your doctor about the appropriate screening method based on your age group. Regular screening has been shown to prevent cervical cancers and save lives. Early detection greatly improves the chances of successful treatment and can prevent any early cervical cell changes from becoming cancer. Being alert to any signs and symptoms of cervical cancer can also help avoid unnecessary delays in diagnosis.
The tests for cervical cancer screening are the HPV test and the Pap test. These tests can be done alone or at the same time (called a co-test) and are done during a pelvic exam.
The HPV test is most often used in 2 situations:
- The American Cancer Society recommends the primary HPV test* as the preferred test for cervical cancer screening for people 25-65 years of age. (*A primary HPV test is an HPV test that is done by itself for screening. The US Food and Drug Administration has approved certain tests to be primary HPV tests.)
- Some HPV tests are approved only as part of a co-test, when the HPV test and the Pap test are done at the same time to screen for cervical cancer. Because a primary HPV test may not be an option everywhere, a co-test every 5 years or a Pap test every 3 years are still good options.
The result of the HPV test, along with your past test results, determines your risk of developing cervical cancer. If the test is positive, this could mean more follow-up visits, more tests to look for a pre-cancer or cancer, and sometimes a procedure to treat any pre-cancers that might be found.
A health care professional first places a speculum inside the vagina. The speculum is a metal or plastic instrument that keeps the vagina open so that the cervix can be seen clearly. Next, using a small spatula or brush, a sample of cells and mucus is lightly scraped from the exocervix. A small brush or a cotton-tipped swab is then inserted into the opening of the cervix to take a sample from the endocervix . If your cervix has been removed (because you had a trachelectomy or hysterectomy) as a part of the treatment for a cervical cancer or pre-cancer, the cells from the upper part of the vagina (known as the vaginal cuff) will be sampled. The samples are then looked at in the lab.
- HPV vaccine: Vaccines are available that can help protect children and young adults against certain HPV infections. These vaccines protect against infection with the HPV types most commonly linked to cancer, as well as some types that can cause anal and genital warts. The American Cancer Society recommends: - HPV vaccination of children between the ages of 9 and 12.
- Limit exposure to HPV: HPV is passed from one person to another during skin-to-skin contact with an infected area of the body. Although HPV can be spread during skin to skin contact − including vaginal, anal, and oral sex − sex doesn't have to occur for the infection to spread. All that is needed is skin-to-skin contact with an area of the body infected with HPV. This means that the virus can be spread without sex. It is even possible for a genital infection to spread through hand-to-genital contact.
- Use a condom: Condoms (“rubbers”) provide some protection against HPV but they don’t completely prevent infection. One reason that condoms cannot protect completely is because they don’t cover every possible HPV-infected area of the body, such as skin of the genital or anal area. Still, condoms provide some protection against HPV, and they also help protect against HIV and some other sexually transmitted infections.
- Do not smoke: Not smoking is another important way to reduce the risk of cervical pre-cancer and cancer.
- Children and young adults aged 13 through 26 who have not been vaccinated, or who haven’t gotten all their doses, should get the vaccine as soon as possible. Vaccination of young adults will not prevent as many cancers as vaccination of children and teens.
Know the facts, risk factors, and cancer screening options. View and download educational material below.