Pelvic Exams and Pap Tests

Increase Early Detection, Reduce Risk

The best chance for preventing and treating cancer is early detection. That’s why it’s essential for women to have regular pelvic exams and Pap tests.

A woman’s primary care physician, internal medicine specialist, an obstetrician/gynecologist (OB/GYN) or another trained health professional, such as a physician assistant, nurse midwife or nurse practitioner, can perform the exam.

During the pelvic exam, the physician will check the health of the reproductive organs and may perform a Pap test (sometimes called a Pap smear). A Pap test is a way to examine cells collected from the cervix, or the opening of the womb (located at the top of the vagina), for the presence of infection, inflammation, abnormal cells, precancerous changes or cancer. This test offers a woman the best means of early detection.

Why is a Pap Test Recommended?

A Pap test, along with a pelvic exam, is an important part of a woman's routine health care because it may detect abnormalities that can lead to invasive cancer. Most cancers of the cervix can be detected early if women have Pap tests and pelvic examinations regularly. As with many types of cancer, cancer of the cervix is more likely to be successfully treated if it is detected early.

The Pap test is useful for detecting not only cancerous cells, but also other cervical and vaginal abnormalities including dysplasia (precancerous cells) and inflammation. Inflammation may be caused by:

• Yeast infections
• Trichomoniasis infections
• Bacteria
• Viruses
• Medications or other chemicals

Who Should Have Pap Tests?

A woman should always consult with her doctor about when and how often a Pap test and pelvic examination should be performed.

According to the National Cancer Institute, the American Cancer Society (ACS), and the American College of Obstetricians and Gynecologists (ACOG), general guidelines include:

• Cervical cancer screening should begin at age 21 for all women, including those who are not sexually active.
• Women ages 21-29 should have cervical cytology screening with regular Pap tests every three years.
• At or after age 30, women should be screened with Pap tests every three years, or screened with a Pap test and HPV testing (co-testing) every 5 years for those that want to lengthen the interval between screenings.
• Women over 65 years of age who have had regular screening with normal results and have no history of precancer within the last 20 years should not be screened for cervical cancer, according to the ACS.
• Women who have had a total hysterectomy.
• Women who have been vaccinated against HPV.