With cervical cancer screening, we can often find cancer early, before it has spread. We can even see changes to the cervix that happen before cancer develops. By treating these pre-cancerous changes, we’re effectively stopping cancer before it starts.

When we find cancer early, we have more options to treat you and a better chance of curing your cancer. If you want biological children, it also means you may have the option of keeping your uterus, instead of removing it during a hysterectomy.

Cancer screening also includes tests to identify HPV infections. By monitoring these infections, we can intervene earlier as needed to prevent cancer.

Which cervical cancer screening you should get and when you should get it depends on your age and other risk factors. Your primary care clinician or gynecologist can help you decide which makes sense for you.

There are 3 main types of cervical cancer tests.

Pap test

You may know this as a cervical cancer screening Pap smear. Your doctor may call it a cervical cytology test. It’s all the same test. 

This test looks for changes in cervical cells caused by human papillomavirus (HPV). Left untreated these cells may turn into cancer.

A Pap smear can find precancerous cells and cervical cancer cells. It can also find noncancerous conditions, such as inflammation or infection.

High-risk HPV test

With high-risk HPV (hrHPV) testing, we check for infections that can cause cervical cancer, which are very common.

Pap/hrHPV co-testing

This test combines a Pap smear and the hrHPV test in one.

At Carilion, we recommend people aged 21 to 29 get a cervical cancer screening Pap smear every 3 years.

Carilion strongly recommends starting HPV-based screening (either co-testing or HPV only every 5 years) at age 25. This is due to the higher rate of cervical cancer in Southwest Virginia—and more deaths from it.

Carilion recommends continuing this screening at least every 5 years until age 65. If you’ve had abnormal results in the past, you may need follow-up screening more often.

If you’re older than 65, talk to your doctor about whether you need to continue screening. Doctors find most cervical cancer in people younger than age 65. 

Carilion recommends stopping screening at 65—but only if:

• You’ve had screenings regularly
• Had clear screenings for 10 years
• Had no advanced abnormal cells on the cervix in the last 25 years 
• Are otherwise at average risk for cervical cancer

You can also stop screening after a hysterectomy with removal of the cervix, but only if you haven’t had advanced abnormal cells on the cervix in the last 25 years

Your doctor may recommend screening more often if you're at high risk for cervical cancer. You may also need continued screening beyond age 65 if you haven't had regular screenings. 

Do I need cervical cancer screening if I had the HPV vaccine? 

HPV infections cause most cervical cancers. There are many strains of HPV. High-risk HPV strains, or hrHPV, are the leading cause of cervical cancer and can cause other cancers, such as cancers of the vagina, throat, anus, and penis.

The HPV vaccine can prevent most HPV infections that cause cervical cancer and some other cancers. However, the HPV vaccine doesn't prevent all high-risk HPV infections. Even if you have received the HPV vaccine, you still need routine cervical cancer screening.

At Carilion, routine cervical cancer screening is part of your annual gynecological exam. 

Collecting the cervical cancer cells for screening takes place during a pelvic exam. You'll lie on your back, with your knees bent and your feet in the supports at the end of the exam table.

The healthcare clinician uses a tool called a speculum to open your vagina. This helps them see your cervix. You may feel a slight pressure.

They then use a tiny spatula and brush to scrape a sample of cells from your cervix. You may feel a slight pinch or discomfort for a few seconds. You may also have some minor bleeding.

Under certain conditions, you may be able to do your own swab to detect HPV, but this isn't yet routinely offered. Please discuss this with your clinician.

We send the sample to a lab where pathologists check it for abnormal cells or signs of infection. You can expect your test results in a few days.

Risks of cervical cancer screening

Screening tests can find cancer early, lowering your chance of dying from cervical cancer. However, there are a few potential negatives to consider with cervical cancer screening.

Potential risks of cervical cancer screening include:

• False-positive results: The cells may look abnormal even though there's no precancer or cancer. False-positive results can mean more tests and procedures to confirm the findings, which can have unintended harms. False-positive results can also cause anxiety.
• False-negative results: Sometimes the cells can look normal, even though you may have precancer or cancer. False-negative results may delay treatment.