By Cynthia A. Gelb
Not that long ago, women were told to get a Pap test every year. And most of us did, even though it wasn’t always clear why we were being tested. We just did what we were told and thought it was a surefire way to stay healthy. But times and recommendations have changed about what test to have, how often to have it, and the reason to have it.
Women Need More Information
Women are confused about their reproductive health. As the director of the Centers for Disease Control and Prevention’s (CDC’s) Inside Knowledge: Get the Facts About Gynecologic Cancer Campaign, it’s my job to find out what women think and know about the five most common gynecologic (GYN) cancers: cervical, ovarian, uterine, vaginal, and vulvar cancers.
We recently heard from 168 women in 21 focus groups conducted in English and Spanish in three cities across the United States. Every one of the women knew they should get a Pap test. Although most correctly said that the Pap test screens for cervical cancer, many mistakenly believed that it also tests for ovarian and uterine cancers and other conditions. Furthermore, the majority of women had never heard of the human papillomavirus (HPV) test and had no idea if they had received it. And most believed that they should get a Pap test every year, even if their doctors advised them to wait longer or to stop getting screened altogether.
These are the facts about screening for gynecologic cancers:
The Pap test is recommended to screen for cervical cancer. The other GYN cancers have no screening test. Women should see a doctor if they have any unusual symptoms for two weeks or longer. And if they have vaginal bleeding after menopause or after sex, or longer or heavier periods than are normal for them, women should see a doctor right away. Chances are it’s not cancer, but it’s important to find out what’s causing symptoms. Find out more about GYN cancer symptoms.
- Two tests are recommended to help prevent cervical cancer or find it early, when treatment works best:
- The Pap test looks for cell changes on the cervix that might become cervical cancer if they are not treated appropriately.
- The HPV test looks for the virus that can cause these cell changes.
- Women should begin having Pap tests at age 21. If the result is normal, they should have the test every three years.
- Beginning at age 30, women can choose from the following test options:
- Pap test only every three years, provided the previous test results were normal
- HPV test only (i.e., primary HPV testing) every five years, provided the previous test results were normal
- HPV test along with the Pap test (i.e., co-testing) every five years, provided both test results were previously normal
- Women aged 65 can stop screening if they’ve had normal screening test results for several years or if their cervix was removed as part of a total hysterectomy.
Patient Education for GYN Cancer Screening
Oncology nurses can help their female patients understand their screening test options. Please let your patients know what tests are available, what test they’re getting, what it screens for, and how long they can wait before doing it again. We have heard again and again that women are eager for more information, not less. You can find more information about gynecologic cancers through CDC’s Inside Knowledge Campaign.
You may also want to tell your patients about free or low-cost screening services for women. CDC’s National Breast and Cervical Cancer Early Detection Program provides breast and cervical cancer screening and diagnostic services to low-income, uninsured, and underinsured women across the United States.