Healthcare professionals rely on regular cervical screening for cancer prevention. During this procedure, your cervix, which is the opening of the uterus, will be checked for abnormal cells and the human papillomavirus (HPV). This is usually done using a Pap smear, where a healthcare professional will swab your cervix to collect cells. These are sent to a lab to determine if they are normal or abnormal. If they’re abnormal, this can indicate changes on your cervix that can lead to cancer.
HPV is the most common sexually transmitted infection (STI) and the leading cause of cervical cancer. It also causes over 90% of abnormal cells found during cervical screenings.
Because HPV can remain dormant for years, many people don’t know they have the virus. Regular cervical screening is therefore important for early diagnosis and treatment.
It is generally advised that women over 21 have regular Pap smears. If HPV is found during cervical screening but no abnormal cells are seen, you will normally only need another Pap smear in one year. If you still have HPV after three years, you will likely need to have a colposcopy.
How Often Do You Need A Pap Smear?
Women aged 21 to 65 are advised to have a Pap smear every three years. Women aged 30 and older may be able to test every five years if the procedure includes HPV testing. If you are older than 65 and have never had an abnormal Pap smear, you can usually stop routine screening.
Certain risk factors may require you to have more frequent Pap smears. These include:
- Cervical cancer or precancerous cells on a previous Pap smear
- Exposure to diethylstilbestrol (DES) in utero
- Weakened immune system due to an organ transplant, chemotherapy, or ongoing steroid use
- A history of smoking
What Is Dyskaryosis?
Dyskaryosis is the appearance of abnormal cells on the cervix. Most women who have a Pap smear will receive a normal result. However, around 1 in 20 smear test results will come back as abnormal. These often indicate an HPV infection.
An abnormal result does not mean that you have cervical cancer; it does indicate that changes have been found in your cervical cells that require further investigation. A colposcopy is usually the next step in determining a diagnosis and whether treatment is needed.
What Is A Colposcopy?
A colposcopy uses a special microscope (colposcope) to magnify the cervix. It helps healthcare professionals identify abnormalities on the cervix that may become cancerous if untreated.
During this procedure your cervix might be swabbed with a vinegar solution, which causes unhealthy cells to change colour. If your doctor finds unhealthy cells, a small biopsy may be performed.
What Is A Cervical Biopsy?
During a cervical biopsy, your doctor removes a small tissue sample from your cervix. This is then tested for cancer or for abnormal or precancerous cells.
Doctors usually perform cervical biopsies after abnormalities are found during a pelvic exam, Pap smear, or colposcopy. They may also collect a biopsy if you’ve tested positive for HPV. Biopsies can sometimes be used to completely remove abnormal or precancerous cells.
These also help doctors diagnose other conditions, which include:
- Polyps (noncancerous growths on the cervix)
- Genital warts – these can indicate HPV, a major risk factor for cervical cancer.
- Diethylstilbestrol (DES) exposure. You may be at increased risk of developing cancer of the reproductive system if your mother took DES during pregnancy.
Frequently Asked Questions
HPV is the acronym for the human papillomavirus. This is a sexually transmitted infection and the most common STI in the UK, affecting both women and men. HPV can cause reproductive cancers, including cancer of the cervix, vulva, vagina, penis, or anus.
If you are a woman between 21 and 65, you should have a Pap smear at least every three years. If you are 30 or older, you only need a Pap smear every five years if you test for HPV at the same time. You doctor can advise on this.
When you have a total hysterectomy, your cervix is removed with the rest of your uterus, and you will likely no longer have to have Pap smears. However, if you had a hysterectomy for a precancerous or cancerous condition of the cervix, you will likely need to continue having regular screening.