Female-Specific Cancer
Screening

Cancer screening becomes more important as we grow older, particularly if we have been exposed to risk factors such as smoking or hazardous chemicals, or if we have a family history of cancer.

Why it is Recommended

BREAST CANCER
Women should have regular breast exams – self-exam monthly and clinical exam every 1 to 3 years for women aged 30 to 39.  Women 40 and over should have an exam consisting of mammography every one to two years, with an optional clinical breast examination (CBE).

CERVICAL CANCER
Women who are over 18 or sexually active and who have a cervix should have annual Pap tests to screen for cervical cancer.  If the results are normal for three or more consecutive tests, they may be performed at the discretion of the physician, not less than every 3 years.

A Pap smear is a test that checks for changes in the cells of your cervix.  Developed over forty years ago by Dr. George Papanicolaou, this test can help to detect cervical cancer at an early stage, while it is easier to treat.

Pap smears have made it possible to detect precancerous and cancerous conditions before they progress to cancer which could spread to other parts of the body, and have saved thousands of women's lives by catching cancers before they spread.

Pap smears are not 100% accurate.  "False-negative" results occasionally appear: normal cell growth is indicated by the test when in fact abnormal cells are present.  False-negative tests can occur for several reasons, for example no abnormal cells being contained in the sample, or too many or too few cells being present to allow an accurate reading.  An infection could also cover up abnormal cells.  If a Pap smear is performed on a regular basis, the chances of a problem going undetected are much lower.

When preparing for a Pap smear, do not douche or use vaginal creams for two days prior to the test.  Do not have intercourse within twenty-four hours of the test because it could cause inaccurate test results.

A Pap smear only takes a few moments to collect and is a part of a routine pelvic examination.  You will be asked to lie on your back, with your knees bent and feet apart.  Your clinician will insert a speculum, without lubricant, into the vagina so that the cervix can be seen.  Your clinician will use a special swab, brush or stick to wipe off cells from inside the opening of the cervix and from the outer part of the cervix.  These cells are smeared onto a microscope slide and taken for analysis.

If the cells appear normal, no treatment is necessary.  If an infection is present, treatment is prescribed.  If the cells appear abnormal, more tests may be necessary and, depending on the severity of the dysplasia, treatment should begin.

The frequency of the Pap smear test can vary from every six months to every three years depending on a woman's risk level.  These factors include age at the time of first sexual intercourse; having (had) multiple sex partners; a history of herpes infection or venereal warts; previously abnormal Pap smears.

Cervical cancer could be eliminated as a cause of death if all women had an annual Pap test.  Unfortunately fewer than 49% of all women take the test.  Controversy regarding cervical cancer screening concerns the upper age limit for screening and the appropriate frequency.  Most guidelines recommend that screening begin when a woman becomes sexually active or by age 18-21.  Because mortality increases with advancing age it seems imprudent not to screen older women.  Most cancer organizations recommend that screening be done on a yearly basis until there have been three consecutive normal examinations.