Your biggest questions about cervical cancer screenings, answered

Keeping up with regular cervical cancer screenings is one the best things you can do for your health. And thanks to modern testing methods, cancer of the cervix (the opening of your uterus) has become more preventable than ever before.  

Today, there are several simple tests that help doctors find and treat precancers before they turn into cervical cancer. And you can get the tests right at your gynecologist’s office.   

Below, you’ll find answers to some key questions you might have about cervical cancer screenings.  

What causes cervical cancer in the first place? 

Cervical cancer is primarily caused by a virus called the human papillomavirus (HPV). According to the Centers for Disease Control and Prevention (CDC), HPV is responsible for nearly all cervical cancer cases. 

HPV is spread through sexual skin-to-skin contact and is extremely common. Nearly everyone (men and women) will be infected with HPV at some point in their life, says the CDC. HPV infection often has no symptoms, so you could have had it without knowing it. 

How is the screening test done? 

Your gynecologist typically does a screening test as part of your annual pelvic exam. There are two types of tests: a Pap test and an HPV test. The tests can be done alone or at the same time. 

Your doctor will examine your vagina with a special instrument so they can see your cervix. Then they’ll take a sample of cervical cells and send them to a lab: 

• A Pap test checks for abnormal cells that may be an early sign of cervical cancer.  
• The HPV screening checks for infection with certain strains of HPV that are known to lead to cervical cancer.   

“The HPV test lets you know if you’ve been exposed, and the Pap test determines whether the exposure has affected the cells and whether additional steps are needed,” says Sarah Dilley, M.D., a gynecologic oncologist in Atlanta. 

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Which screening test should I get, and how often should I be screened? 

You generally need to get screened every three to five years. Here’s what the U.S. Preventive Services Task Force recommends:  

If you’re 21 to 29, get a Pap test every three years.

If you're 30 to 65:

• You can keep getting a Pap test every three years. 
• You can switch to getting an HPV test every five years. 
• You can get a combo Pap test and HPV test every five years. 

Your doctor will help you decide which test you need and how often to be screened. You may need to get tested more often if you are at high risk — such as if you have HIV or a weakened immune system, or had a recent abnormal screening test for cervical cancer. 

What do Pap and HPV tests show? 

A lab technician will analyze the cells. For a Pap test, they will determine if the cells are normal, unclear, abnormal, or unsatisfactory. For an HPV test, the results will show if you are positive or negative for HPV. 

“A suspicious Pap test can require a follow-up colposcopy to examine the cervix more closely,” says Dr. Dilley. A colposcopy is a visual exam of the cervix to check for cancerous cells. It can sometimes also lead to a biopsy, where a sample of tissue is removed for further testing. 

After a positive HPV screening, your doctor will want to do more tests. They can reveal whether the virus is still in the cells or if it has traveled to another area in the body. 

Should I worry about an abnormal reading? 

Not quite yet. An abnormal Pap test or a positive HPV test doesn’t automatically mean you have cancer. A mishandled slide or cervical inflammation (which usually does not have symptoms) may be to blame.  

And if your doctor finds more serious changes (precancer) during a colposcopy, it can be treated. You may need a procedure to remove the abnormal cells before they turn into cancer. 

Is there anything I should do (or not do) to prepare for the exam? 

Don’t have sex, douche, or use a tampon immediately before the exam. Try to schedule the test for after your period. Also, make sure to discuss with your doctor any concerns that have been bothering you, as well as any family history of cancer, including cervical cancer. If you think you may have missed an exam, contact your physician’s office as soon as possible and ask if you need to make an appointment. 

What is the HPV vaccine? 

Today, there is a vaccine that can keep people safe from HPV. The CDC recommends that all children get the HPV shot at around age 11 or 12. And even though boys can’t have cervical cancer, it’s important that they are vaccinated to prevent the spread of HPV when they become teens and adults.  You can get the vaccine up to age 26. If you’re between 26 and 45, talk to your doctor about whether you should get vaccinated. 

Do I still need to get screened if I had the HPV vaccine? 

Yes! Vaccinated women will still need regular cervical cancer screenings, because the vaccine protects against most — but not all — HPV types that cause cervical cancer. Also, women exposed to HPV prior to getting the vaccine may not get the full benefit of the vaccine. 

Additional sources:  
HPV statistic: Centers for Disease Control and Prevention 
Cervical cancer screening tests: American Cancer Society 
General background: U.S. Department of Health and Human Services 
Screening guidelines: U.S. Preventive Services Task Force; National Library of Medicine 
Abnormal results: American Cancer Society 
HPV vaccination guidelines: Centers for Disease Control and Prevention 

Blue Cross and Blue Shield of Kansas City is an independent licensee of the Blue Cross and Blue Shield Association. 

This information is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician. Always seek the advice of your doctor or other qualified health provider regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you read in this article. If you think you may have a medical emergency, call 911 or go to the nearest emergency room immediately. Neither Blue KC nor its employees, nor any contributor to this information, makes any representations, express or implied, with respect to the information provided herein or to its use.