print   Print full article

Most deaths from cancer of the cervix (the lower part of the uterus, or womb) can be avoided by having regular gynecological checkups and Pap smears. This is a slow-growing cancer that can take several years to develop. Most often, cancerous cells are seen in women 40 years of age or older. Routine screening can help identify cervical cancer early on, at a time when it is highly curable. Screening can also find precancerous lesions that can be monitored or removed before cancer ever starts to develop.

The American College of Obstetricians and Gynecologists (ACOG) currently suggest that young women under the age of 21 years do not need to see a gynecologist unless there is a medical need. They recommend the following:

  • Pap smears for women younger than 21 are not recommended because the incidence of cancer in this age group is rare. False positive results may occur due to normal cell changes and are somewhat common. The false positive results may generate unnecessary and costly treatment as well as emotional anxiety.

The American Cancer Society and the U.S. Preventive Services Task Force offer similar recommendations.

Teen risk
Experts say that the following situations increase a teen girl's risk for future cervical problems, including cervical cancer:

Under these conditions, the cells of the cervix are more likely to undergo changes in ways that may lead to cancer or future fertility problems. While a Pap smear may not be required, appropriate testing for STDs and counseling regarding safe sex and contraception should be encouraged.

HPV testing
Screening for the presence of human papilloma virus (HPV DNA test) is not recommended for women younger than age 30 because infections with HPV are relatively common in this age group and often resolve without treatment or complications.


Links
American College of Obstetricians and Gynecologists: "Tool kit for teen care: pap tests" available at http://www.medem.com.

To sign up for a personal Pap test scheduling reminder, click here.


Sources

(December 2009). American College of Obstetricians and Gynecology Practice Bulletin Number 109, Cervical Cytology Screening. PDF available for download at http://journals.lww.com/greenjournal/documents/PB109_Cervical_Cytology_Screening.pdf through http://journals.lww.com. Accessed December 2009.

American Cancer Society. Overview: cervical cancer: What causes cancer of the cervix? Can it be prevented? Revised 4 Nov 2003. Available on the Internet at http://www.cancer.org. Accessed 10 Aug 2004; 2006 revision accessed 8 Feb 2008.

American Cancer Society. DES Exposure: Questions and Answers. Available online at http://www.cancer.org/docroot/CRI/content/CRI_2_6x_DES_Exposure_Questions_and_Answers.asp through http://www.cancer.org. Accessed September 2008.

American College of Obstetricians and Gynecologists. Human papillomaviruses and cancer: questions and answers. 8 Jun 2006. Available on the Internet at http://www.medem.com. Accessed 18 Jan 2008.

American College of Obstetricians and Gynecologists. Tool kit for teen care: pap tests. 2003. Available on the Internet at http://www.medem.com. Accessed 17 Jan 2008.

American College of Obstetricians and Gynecologists. ACOG clarifies recommendations on cervical cancer screening in adolescents (news release). 30 Sep 2004. Available on the Internet at http://www.acog.org/from_home/publications/press_releases/nr09-30-04-1.cfm through http://www.acog.org. Accessed 2004 and 18 Jan 2008.

American College of Obstetricians and Gynecologists. Cervical cancer screening: testing can start later and occur less often under new ACOG recommendations (press release). 31 Jul 2003. Available on the Internet at http://www.acog.org/from_home/publications/press_releases/nr07-31-03-1.cfm through http://www.acog.org. Accessed 15 Jul 2004 and 18 Jan 2008.

American College of Obstetricians and Gynecologists. First ob-gyn visit recommended in early teens (news from ACOG). 10 May 2006. Available on the Internet at http://www.medem.com. Accessed 17 Jan 2008.

American College of Physicians. New pap guidelines reduce screening, but raise concerns about compliance. Apr 2003. Observer. Available on the Internet at http://www.acponline.org. Accessed 15 Jul 2004 and 18 Jan 2008.

American Society for Colposcopy and Cervical Pathology. What women should know about HPV and cervical health. 2003. Available on the Internet at http://www.asccp.org/patient_edu.shtml. Accessed 17 Jan 2008.

Smith RA, Cokkinides V and Eyre HJ, for the American Cancer Society. American Cancer Society guidelines for the early detection of cancer, 2003. CA Cancer J Clin 53:27-43. Available on the Internet at http://caonline.amcancersoc.org. Accessed 5 Aug 2004 and 18 Jan 2008.

Solomon D, Papillo J, Davey D, on behalf of the Cytopathology Education and Technology Consortium. Statement on HPV DNA Test Utilization. Am J Clin Pathol 2009;131:768-769.

US Centers for Disease Control and Prevention. Basic facts on screening and the Pap test. Oct 2003. PDF available for download at http://www.cdc.gov/cancer/cervical/pdf/cc_basic.pdf through http://www.cdc.gov. Accessed 2 Aug 2004 and 18 Jan 2008.

US Preventive Services Task Force. Screening for cervical cancer. Release date Jan 2003. Available on the Internet at http://www.ahcpr.gov/clinic/uspstf/uspscerv.htm through http://www.ahcpr.gov. Accessed 15 Jul 2004 and 18 Jan 2008.

US Food and Drug Administration. Cervical Cancer Screening. FDA Consumer Magazine.  January-February 2004. Available online at http://www.fda.gov/Fdac/features/2004/104_cancer.html through http://www.fda.gov. Accessed September 2008.