Oncologist-approved cancer information from the American Society of Clinical Oncology
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Cervical Cancer

This section has been reviewed and approved by the Cancer.Net Editorial Board, 8/2012
Prevention

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Cervical cancer can often be prevented by preventing precancers and having regular Pap tests. Preventing precancers means controlling possible risk factors (see above), such as:

  • Delaying first sexual intercourse until the late teens or older
  • Limiting the number of sex partners
  • Avoiding sexual intercourse with people who have had many partners
  • Avoiding sexual intercourse with people who are obviously infected with genital warts or show other symptoms
  • Having safe sex by using condoms will reduce the risk of HPV infection. Condoms also protect against HIV and genital herpes.
  • Quitting smoking

 The Pap test is the most common test for cervical cancer. Researchers have found that combining it with a test to detect HPV provides the most accurate results. In 2003, a U.S. Food and Drug Administration (FDA) panel recommended that Pap tests and HPV tests be used together when screening for cervical cancer in women older than 29. The HPV test and HPV genotyping (testing the strain of HPV) are already being used as secondary tests for people with Pap test results that show abnormal cells to help doctors determine a woman’s risk for developing cervical cancer.

In 2006, the FDA approved the first HPV vaccine, called Gardasil, for girls and women between ages 9 and 26. The vaccine helps prevent infection from the two HPV strains known to cause most cervical cancers and precancerous lesions. The vaccine also prevents against two low-risk HPV strains that cause 90% of genital warts. In 2009, the FDA approved a second HPV vaccine, called Cervarix, for the prevention of cervical cancer in girls and women ages 10 to 25. These vaccines do not protect people who are already infected with HPV. Doctors still recommend regular Pap tests using the guidelines below for all women. Learn more about HPV vaccination for cervical cancer.  

In 2009, the American College of Obstetricians and Gynecologists updated its guidelines for cervical cancer to recommend the following screening schedule:

  • Starting at age 21, women should have Pap tests every two years.
  • After three normal Pap tests in a row, women 30 and older may have Pap tests every 3 years. Women with specific medical conditions, such as a history of abnormal Pap tests, infection with HIV, a weakened immune system, or exposure to DES, should be screened more often.
  • Women 30 and older may be tested for HPV with the Pap test. If both are normal, the tests are not needed for another three years.
  • Starting at age 65 to 70, women can stop screening if they have had three normal Pap tests in a row in the previous 10 years. However, they should continue screening if they are sexually active, have had multiple sexual partners, or have a history of abnormal Pap tests. 

In 2012, the American Cancer Society and the U.S. Preventive Services Task Force updated their recommendations to the following screening guidelines:

  • All women should begin having Pap tests within three years of beginning vaginal sexual intercourse or by age 21, whichever comes first.
  • Women should be screened every three years with a conventional or liquid-based Pap test. Women 30 and older who have had three normal test results in a row can receive screening every three years. Women older than 30 may also have a Pap test and the HPV test every five years.
  • Women 65 or older can stop screening if their previous three Pap tests were normal and there were no abnormal test results within the previous 10 years
  • Screening after a hysterectomy (removal of the uterus and cervix) is not necessary unless the surgery was done to treat cervical cancer or precancer. Women who have had a hysterectomy without removal of the cervix should continue screening until age 70.

© 2005-2014 American Society of Clinical Oncology (ASCO). All rights reserved worldwide.

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