Cervical Cancer: Screening and Prevention

Approved by the Cancer.Net Editorial Board, 04/2016

ON THIS PAGE: You will find out more about screening for this type of cancer, including risks and benefits of screening. You will also learn about some of the things that a woman can do to reduce the risk of this type of cancer. To see other pages, use the menu.

Prevention 

Cervical cancer can often be prevented by preventing precancers and having regular Pap tests to find any precancers so they can be treated. Preventing precancers means controlling possible risk factors, 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

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 2 HPV strains known to cause most cervical cancer and precancerous lesions called HPV-16 and HPV-18. The vaccine also prevents against 2 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.  

Screening

Screening is used to look for cancer before you have any symptoms or signs. Scientists have developed, and continue to develop, tests that can be used to screen a person for specific types of cancer before signs or symptoms appear. The overall goals of cancer screening are to:

  • Lower the number of people who die from the disease, or eliminate deaths from cancer altogether

  • Lower the number of people who develop the disease

Learn more about the basics of cancer screening.

Screening information for cervical cancer

Bimanual pelvic exam

In this examination, the doctor will check a woman’s body for any unusual changes regarding her cervix, uterus, vagina, ovaries, and other nearby organs. To start, the doctor will look for any changes to the woman’s vulva outside the body and then, using an instrument called a speculum to keep the vaginal walls open, the doctor will look inside the woman’s body. Some of the nearby organs cannot be viewed by the doctor, so the doctor will then insert two fingers of one hand inside the patient’s vagina while the other hand gently presses on the lower abdomen to feel the uterus and ovaries.  This exam typically takes a few minutes and is done in an examination room at the doctor’s office.

Pap test and the HPV test

The Pap test is the most common test for early changes in cells that can lead to cervical cancer. This test is also called a Pap smear. A Pap test involves gathering a sample of cells from the cervix and is often done at the same time as a pelvic exam (see above.)  Researchers have found that combining the Pap test with a test to detect HPV provides the most accurate results. These tests can be done on the same sample of cells removed from the woman’s cervix. 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, which is 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.

Screening recommendations for cervical cancer

Different organizations have looked at the scientific evidence, risks, and benefits of cervical cancer screening. These groups have developed different screening recommendations for women in the United States who have “average risk” of cervical cancer, meaning these women do not have strong risk factors for this disease. 

Decisions about screening for cervical cancer are becoming increasingly individual, with recommendations based on a woman’s age, personal risk factors, and whether she’s had surgery to remove her cervix and uterus called a hysterectomy. It’s important for each woman to talk with her doctor about how often she should receive regular screening tests and exams, and which tests are most appropriate. Here are some questions to ask your doctor:

  • At what age should I start being screened for cervical cancer?

  • Should my screening include a pelvic exam? If so, how often?

  • Should my screening include a Pap test? If so, how often?

  • Should my screening include an HPV test?  If so, how often?

  • At what age could I stop being regularly screened for cervical cancer?

  • Do any of these recommendations change if I have had cervical dysplasia or precancer?

  • Do any of these recommendations change if I have had a hysterectomy?

  • Do any of recommendations change if I have had the HPV vaccine?

All women should talk with their doctors about cervical cancer and decide on an appropriate screening schedule. For women at high risk for developing cervical cancer, screening is recommended at an earlier age and more often than women who have an average risk of cervical cancer.

To view different groups’ national recommendations, visit the websites of the American Cancer Society, the American Congress of Obstetricians and Gynecologists, and the U.S. Preventative Services Task Force. Please note that these links will take you away from this guide to other, independent websites.

The next section in this guide is Symptoms and Signs. It explains what body changes or medical problems this disease can cause. Or, use the menu to choose another section to continue reading this guide.