Everything You Need To Know About Cervical Screenings
Next week is Cervical Screening Awareness Week in the UK, so today we wanted to talk about what exactly cervical screenings (also known as pap smears or smear tests) are. As you might know, regular cervical screenings are the main way to prevent cervical cancer through early detection, and these tests can also be critical when it comes to staying on top of your reproductive health.
Back in January, during Cervical Cancer Awareness month, we had a little check-in with our community and 18% of women over 25 said they had never had a cervical screening whilst 10% said that they had postponed their check-ups because of the pandemic. We want you to feel safe and prepared when it comes to your smear test, so we’re answering all of your questions and concerns about getting cervical screenings during pregnancy, postpartum, and the pandemic.
What are cervical screenings or smear tests for?
In general, cervical screenings are used to identify pre-cancerous cells, check for infection, and ultimately, keep you healthy. Research shows that since the 1950s, when pap smears became available, the rate of cervical cancers has decreased by 60%. Still, about 80% of people get HPV (a leading cause of cervical cancers) at some point in their lives, which makes early detection and screening all the more critical.
Cervical screenings don’t actually test for cancer, but they can help prevent it by catching abnormal cells or human papillomavirus (HPV) before they turn into something more serious (though it’s important to note that many types of HPV don’t cause major health issues or symptoms). These screenings can also help doctors notice any physical changes to your cervix, such as polyps, which are important to know about at any stage of your reproductive journey.
There are typically two types of cervical screenings:
Pap smear. Also called a cervical smear, this tests for abnormal cells in your cervix that could potentially turn cancerous. Cells and mucus are collected by lightly scraping your cervix with a swab. Cervical smears have been shown to lower the incidence of cervical cancer and mortality by at least 80% and generally are covered by insurance as it is a preventative exam. If you’re in a country with universal healthcare, then these are generally free!
HPV test. If the cells in a pap smear come back as abnormal, your doctor may recommend an HPV test as a follow-on. Similar to a pap smear, your doctor will collect a sample of cells with a swab and look for types of HPV that can cause abnormal cells, genital warts, and cancer.
What is HPV and what should I know about HPV?
HPV is the most common sexually transmitted infection (STI) in the US and is highly contagious due to its ability to be transmitted via skin-to-skin contact. There are over 100 different types that range from high-risk to low-risk. The less risky types are treatable and cannot cause cancer, while the higher-risk ones will need to be treated to prevent cancerous cells from developing. It is estimated that about 80% of HPV infections go away naturally and aren’t detectable in 1 to 2 years, however, your doctor will monitor your cervical health and watch for any changes or abnormalities because the earlier they’re seen, the better.
How do I know if I need cervical screening?
If you have a cervix, then it’s recommended you get cervical screening on a regular basis. Women are born with a cervix, but transgender men, non-binary, and intersex people may also have one. Lesbian and bisexual women should also receive screening as HPV infection is still possible through skin-to-skin contact.
Unfortunately discrimination, health insurance policies, and fear of negative experiences can lead people to delay routine medical care, such as routine cervical screenings. For more support on this, people of the LGBTQ+ community can go to the LGBTQ Foundation for more information on navigating cervical screening tests.
Lastly, if you’ve had a hysterectomy with your cervix removed and have no previous history of cervical cancers or abnormalities, you likely don’t need regular pap smears, but this is something to consult with your doctor on as everyone is different.
How often do I need to get a cervical screening?
As with all things health-related, this really depends on you and your unique situation. If you have no known risks for developing cervical conditions, then these are current guidelines on who should get screened with what tests, and when:
Ages 25-49: You should only need a pap smear every 3 years, and only an HPV test if you have an abnormal pap smear.
Ages 50-65: It’s recommended to have a pap smear done every 3 years, or get a pap smear and HPV test together every 5 years.
65 and above: It’s best to speak with your doctor about what’s best for you as you may no longer need regular pap smears or HPV tests. This will depend on if you have had any cancer findings in the last 10 years and how long it’s been since your last screening.
Can I get a cervical screening during the pandemic and is it safe?
Whilst some cervical screenings were canceled and postponed at the beginning of the pandemic (March 2020), services have now resumed and it is safe to go to a cervical screening appointment if they are being provided; your doctor would only offer these services if they feel confident they can protect you and their staff.
We understand that if an appointment was canceled during the last few years, then it may have slipped off your to-do list and not seem so important — but we can’t stress the importance of regular cervical screenings enough. They are vital in catching abnormal cells or human papillomavirus (HPV) before they turn into something more serious. So if your appointment was canceled or you think you are due a check-up contact your GP (in the UK) or Gynecologist (in the US) to check when your cervical screening is due and make an appointment.
Should I get a pap smear if I am trying to conceive?
Cervical screenings should only serve to benefit your chances of getting pregnant because it helps you and your healthcare professional better understand your cervical health and the possible presence of infections. If STIs are left unmanaged it could affect your ability to conceive, but HPV alone isn’t believed to cause fertility problems. However, some types of HPV can increase the risk of cervical cancer which may, in turn, impact fertility.
Treatments for HPV could cause issues like a change in cervical mucus, weakened cervix, or stenosis (when the opening of the cervix narrows which may make it more difficult for sperm to fertilize an egg). People previously thought the HPV vaccine was linked to infertility, but that theory has been fully refuted by evidence showing the HPV vaccine can actually improve fertility by preventing cervical cancers from forming. Just another reason why early action and prevention are so important to your overall health!
Should I get a pap smear during pregnancy, and is it safe?
During your early prenatal visits, your doctor will review your cervical health and examine your cervix to see if any abnormalities are found. If there are, you can get treatment early on in pregnancy. Pap smears and HPV tests are safe during pregnancy and research shows they are not linked to pregnancy complications. Also, many types of HPV aren’t likely to cause complications during pregnancy so your doctor will recommend the best course of action based on your personal condition.
You can have a pap smear up to week 24 in pregnancy, but after that, it’s advised to wait until 12 weeks postpartum, as it could be uncomfortable and findings might not be accurate due to changing hormonal levels.
How common are abnormal pap smears?
Most pap smears come back normal, however, if yours comes back with abnormal results, don’t panic. It’s not out of the ordinary to have an abnormal smear, and it does not mean you have cervical cancer. It only means that some cells are abnormal and worth a follow-up visit just to get everything checked out.
Are there ways to lower my risk of cervical cancer overall?
Yes of course! Here are the top 3 ways to lower your risk of cervical cancer:
Regular screenings and the HPV vaccine. Up to 93% of cervical cancers can be prevented by proper screening and the HPV vaccine. The American Cancer Society says the most important way to prevent cervical cancer is by getting tested regularly and getting the HPV vaccine if you haven’t already. This vaccine protects you from the types of HPV that cause most cervical cancers and genital and anal warts. If you are pregnant, you should wait until after pregnancy to receive the HPV vaccine. Staying up to date on all recommended vaccines can help lower your risk of other cancers as well.
Limit exposure to HPV with safe sex practices. HPV is spread through skin-to-skin contact, meaning if you touch HPV with your hand it is possible to spread it to the genitals touched by the same hand. Using condoms, dental dams, or other protective measures are great ways to keep both partners safe. Keep in mind that HPV does not only appear in the genitals but can also be found in the mouth and anus. Unfortunately, there is not a test for men currently, so physical examination for warts and skin abnormalities is the only way for a male partner to be informed of their potential HPV status.
Refrain from smoking. Smoking is a big risk factor for… a lot of things. It increases your risk for many diseases and cancers, including cervical cancer, as women who smoke are more than 2x as likely to develop cervical cancer. If you’re having trouble quitting, here are some resources we hope can help:
How To Quit Smoking - CDC
Stop Smoking Services - NHS
Step-by-Step How To Quit Smoking - Australian Government
Information, resources, and support
US:
UK:
Do you have any questions about cervical screenings? Let us know in the comments and we’ll get back to you.
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