Causes & Risk Factors
The main risk factors for cervical cancer are related to sexual practices. Sexually transmitted infections (STIs) may make the cells more likely to undergo changes that can lead to cancer. STIs include HPV, herpes, gonorrhea and chlamydia. HPV is the virus that can cause genital warts. It seems to be very closely connected with these changes.
Risk factors for cervical cancer
- Starting to have sex early (before age 18)
- Having had many sexual partners (Sexual Promiscuity)
- Being infected with a sexually transmitted infection (STI) or having had a sex partner who has an STI
Abnormal cervical cell changes rarely cause symptoms. But you may have symptoms if those cell changes grow into cervical cancer. Symptoms of cervical cancer may include:
- Bleeding from the vagina that is not normal, such as bleeding between menstrual periods, after sex, or after menopause.
- Pain in the lower belly or pelvis.
- Pain during sex.
- Vaginal discharge that isn’t normal.
Diagnosis & Tests
What happens during a Pap smear?
During a Pap smear, your doctor will put a special instrument called a speculum into your vagina. This helps open your vagina so the doctor can see your cervix and take a sample. Your doctor will gently clean your cervix with a cotton swab and then collect a sample of cells with a small brush, a tiny spatula or a cotton swab. Your doctor will put this sample on a glass slide and send it to a lab to be checked under a microscope.
What do the results mean?
A normal Pap smear means that all the cells in your cervix are normal and healthy. An abnormal Pap smear can be a sign of a number of changes in the cells on your cervix, including:
- Inflammation (irritation). This can be caused by an infection of the cervix, including a yeast infection, infection with the human papillomavirus (HPV), the herpes virus, or many other infections.
- Abnormal cells. These changes are called cervical dysplasia. The cells are not cancer cells, but may be precancerous (which means they could eventually turn into cancer).
- More serious signs of cancer. These changes affect the top layers of the cervix but don’t go beyond the cervix.
- More advanced cancer.
If the results of your Pap smear are abnormal, your doctor may want to do another Pap smear or may want you to have a colposcopy. A colposcopy gives your doctor a better look at your cervix and allows him or her to take a sample of tissue (called a biopsy).
How often should I have a Pap smear?
- Every 3 years beginning at 21 years of age and continuing until 65 years of age
- Within 3 years of when you start having sex if you are younger than 21 years of age
- If you are between 30 and 65 years of age and you want to have Pap smears less often, talk to your doctor about combining a Pap smear with human papillomavirus (HPV) testing every 5 years
Certain things put you at higher or lower risk for cervical cancer. Your doctor will consider these when recommending how often you should have a Pap smear.
If you’re older than 65 years of age, talk with your doctor about how often you need a Pap smear. If you’ve been having Pap smears regularly and they’ve been normal, you may not need to keep having them.
If you’ve had a hysterectomy with removal of your cervix, talk with your doctor about how often you need a Pap smear.
If you’ve never had a high-grade precancerous lesion or cervical cancer, ask your doctor how often you need a Pap smear.
How reliable is the test?
No test is perfect, but the Pap smear is a reliable test. It has helped drastically lower the number of women who die of cervical cancer.
Sometimes the test may need to be redone because there were not enough cells on the slide. The lab will tell your doctor if this happens.
ThinPrep, PAPNET and FocalPoint are ways to make Pap smears more accurate. ThinPrep is a way of preparing the sample of cells that makes it easier to spot abnormalities. PAPNET and FocalPoint are computer systems that help lab technicians find abnormal cells. These options may not be available in all areas, and they may increase the cost of a Pap smear.
What should I do before the test?
Plan to have your test done at a time when you aren’t having your menstrual period. Don’t douche, use a feminine deodorant or have sex for 24 hours before the test.
Is there anything I can do to avoid getting cervical cancer?
You may be able to reduce your risk of cervical cancer if you:
- Delay sexual intercourse until you’re 18 years of age or older.
- Make sure both you and your partner are tested for sexually transmitted infection (STIs).
- Limit your number of sex partners.
- Always use latex condoms to protect against STIs. (Remember condoms aren’t 100% effective.)
- Avoid smoking.