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- A recent study of more than 47,000 women found that many weren’t up to date on the Pap smear, a test that screens for cervical cancer.
- The study’s author said the rate of cervical cancer screening in this population was “unacceptably low.”
- Anyone who can get cervical cancer should start getting Pap smears at age 21, according to expert recommendations.
- How often you get tested depends on your age and your test results.
Cervical cancer used to be the top cause of cancer-related death for American women, but cases and deaths related to the disease have dropped significantly in recent decades, according to the Centers for Disease Control and Prevention (CDC). This decline happened largely thanks to widespread adoption of the Pap smear, a screening test that catches abnormalities in cervical cells well before cancer develops.
But a new study suggests that many younger women may now be skipping out on this important test.
For the study, published in January in the Journal of Women’s Health, researchers used medical records to determine cervical cancer screening rates among more than 47,000 Minnesota women from 2005 to 2016.
They found that, in 2016, less than two-thirds of the women ages 30 to 65 were up-to-date with their screenings. The rates were worse among those ages 21 to 29: Only about half of the women in this age group were up-to-date on their screenings in 2016.
The researchers also found racial disparities that MacLaughlin called “especially concerning.” In the study population, African-American and Asian women were less likely to be current on their Pap smears than white women.
“We, as clinicians, must start thinking outside the box on how best to reach these women and ensure they are receiving these effective and potentially life-saving screening tests,” MacLaughlin said in the statement.
Not sure whether or not you’re due for a Pap smear? Here’s a simple guide to the test itself and how often you should get it.
A Pap smear may be uncomfortable, but it shouldn’t be painful
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The Pap smear – named for its creator, Greek researcher Georgios Papanicolaou – is a quick test.
First, a doctor inserts a speculum into your vagina to hold it open. Then, they use a small, brush-like tool to gently scrape some cells from your cervix.
“You’re going to feel some discomfort, but it should not be painful,” Dr. Jessica Shepherd, OB-GYN and gynecologic surgeon at Baylor University Medical Center, told INSIDER. “If anyone ever feels pain during a pelvic exam or a Pap smear, then I think that that should be voiced.”
The sample of cells is sent to a lab, and your doctor’s office will contact you with the results later. If you get a normal result, you’re good until your next test. If you get an abnormal result, you don’t necessarily have cancer. Most abnormal Pap results are caused by human papillomavirus (HPV), a common sexually transmitted infection that typically clears up on its own. But certain high-risk strains of the virus can cause cervical cancer. In fact, HPV is thought to be responsible for more than 90% of cervical cancers, according to the CDC.
That means your doctor may need you to come back for further testing to determine how severe your abnormalities are and which HPV strain you might have, according to the American College of Obstetricians and Gynecologists (ACOG).
The frequency of testing depends on your age
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The ACOG’s current recommendation is that women ages 21 to 29 get a Pap smear every three years. (If you’re younger than 21, you don’t need the test yet.)
“This is for people who have normal results with no abnormalities,” Shepherd said. “If the result of your Pap is abnormal, the recommendations will change and you may have to have one every year. Make sure you follow the recommendations of your OB-GYN.”
For those ages 30 to 65, the ACOG recommends any one of three options: a Pap smear every three years, an HPV test every five years, or a Pap smear plus an HPV test every five years. (An HPV test is done the same way as a Pap smear, Shepherd said.)
In this age group, the rate of cervical cancer is higher, Shepherd said, hence the additional testing.
“We know that the leading cause of cervical cancer is exposure to HPV, so that’s why testing for HPV is helpful,” she said. “Because we know that if a person has been HPV-exposed, we would follow them a little bit more closely.”
The Pap smear isn’t the only key player in the fight against cervical cancer
A Pap smear can help detect cervical cancer, but the HPV vaccine helps prevent it from happening in the first place.
HPV can lead to more than just cervical cancer. Some anal, vaginal, vulvar, penile, and throat cancers are also caused by the virus, according to the CDC.
The safe and effective vaccine protects against several cancer-causing strains of HPV. The CDC estimates that the shot could prevent more than 90% of the 33,700 cancers caused by HPV every year in the US.
The CDC recommends the HPV vaccine for kids ages 11 through 12 because it’s most effective when the person getting the shot hasn’t yet had any exposure to the virus via sexual activity. But for anyone who missed their chance when they were younger, the agency also recommends the shot for many young adults up to age 26.
If you’re over 26, things are a bit more complicated.
In October 2018, the FDA announced that it had approved the HPV vaccine for people up to 45 years old. The approval was based on new research showing that, in older adults, the vaccine is still highly effective in preventing HPV infection, genital warts, and some precancers and cancers, the New York Times reported.
Unfortunately, insurance may not cover the vaccine for people over 26. As of this writing, the CDC’s recommendations for who should get vaccinated have not changed to reflect the FDA’s expanded approval, and insurance companies will be far more likely more to cover the cost of the shot if it’s recommended by the CDC, the Washington Post reported in October.
For now, if you’re older than 26, you may have to pay out of pocket for the vaccine, which could cost between $400 and $500, according to CNN. Talk with your doctor to determine the best choice for you.
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