Thanks to the commercials for Gardasil, the vaccination against HPV (human papillomavirus), more women of all ages know of its connection to cervical cancer. But do they realize that eight out of 10 adults will have HPV at some point in their lives? Or that cervical cancer remains the second most common cancer in women worldwide, despite the fact that the pap test has been available for over 50 years? With the knowledge that high-risk types of HPV are the causal agents of cervical cancer, the recommendations for screening have changed to sometimes include testing for HPV DNA.
For young women under the age of 30, HPV infections more often tend to be transient due to an effective response by the immune system. This age group is at low risk for cervical cancer, so HPV testing is recommended only when pap results are inconclusive. In this case, checking a woman’s HPV status is advised as a means to direct any further testing that may be necessary.
For women 30 and older, the risk of cervical cancer increases and the immune system may not fight off the virus as effectively resulting in a persistent HPV infection. Therefore, testing for HPV DNA is recommended along with a Pap test. This information allows the health care provider to know with greater confidence the risk of each individual for developing cervical disease and cancer. This additional testing may allow a longer interval between Pap tests, every two to three years, or may encourage closer screening intervals, every four to six months or may indicate the need for more detailed tests, specifically a colposcopy which looks directly at the cervix with the aid of magnification.
Other changes in the recommendations from governing bodies include when to stop doing Pap tests. If a woman has had a hysterectomy (surgical removal of uterus and cervix) due to benign reasons such as bleeding, pain, fibroids or endometriosis and has no history of abnormal cervical findings, there is no need for an annual pap test. The American Cancer Society and the Society for Gynecologic Oncologists recommend that at age 70, a Pap smear is no longer necessary as long as the woman has had regular previous screenings with no abnormalities in the last ten years. These women still need an annual pelvic evaluation in order to assess for other conditions of the urogenital tract.
To schedule a Pap and/or HPV test, please call Caring for You at 661-284-2400.