Widespread use of the Pap test has made cervical cancer screening a success in the United States. Before 1955, cervical cancer was a leading cause of cancer deaths among women. Then, by 1992, the cervical cancer death rate fell by almost 70 percent, according to the American Cancer Society.
The Pap test, done as routine screening, is usually the first step in determining the health of a woman’s cervix. It’s “often considered the most successful cancer screening program the world has seen,” says Dr. Giuseppe Del Priore, National Director of Gynecologic Oncology at our hospitals.
A Pap test is relatively pain-free and takes only a few minutes. During the test, your doctor inserts a swab into the vagina and takes a sample of cells from the cervix. Those cells are examined under a microscope to identify changes in the cervix. Precancerous cells can be treated, which can prevent cancer from developing.
“In the United States, it’s taken cervical cancer from a leading cause of death for women down to relatively uncommon, but still too frequent,” Del Priore says in one of 12 videos in which he discusses issues related to gynecologic cancers. The American Cancer Society estimates that 12,360 women will be diagnosed with invasive cervical cancer this year.
While the Pap test has been a hero in the fight against cervical cancer, efforts to improve screening have been under development. The FDA in April approved an HPV DNA test as a primary screening tool to detect cervical cancer in women aged 25 or older and to assess future risk of the disease.
Human papillomavirus (HPV) infections cause virtually all cases of cervical cancer. More than 100 types of HPV exist but two high-risk strands, known as HPV 16 and HPV 18, are responsible for 70 percent of all cervical cancer cases, according to the National Cancer Institute.
The HPV DNA test specifically picks out HPV 16 and HPV 18, as well as 12 other high-risk HPVs. A positive test result would require further testing—either a colonoscopy if HPV 16 and HPV 18 are detected or a Pap test if one or more of the 12 other high-risk HPV types are detected. The Pap test helps determine if a colonoscopy is needed. Read more about the HPV DNA test in a blog post by Dr. Justin Chura.
Guidelines for cervical cancer screening have not changed in response to the newly approved HPV DNA test. The Society for Gynecologic Oncology and the American Society for Colposcopy and Cervical Pathology are working on interim guidelines, which may come out this summer.
“In general, use of any of the highly sensitive HPV testing, along with a traditional Pap smear, can reduce your risk,” Dr. Del Priore says. “An individual should discuss with her particular physician what the proper screening is based on her risk factors.”
If you have questions about cervical or other gynecologic cancers, tweet us at @CancerCenter with the hashtag #askCTCA. Our National Director of Gynecologic Oncology, Dr. Del Priore, will answer a select group of questions on video next month.
View our Gynecologic Cancer Q&A.