The long-predicted day has finally come. There is cause for great rejoicing. Why? Because after years of research, the American Cancer Society has recently recommended self-swabbing as an acceptable way to check for cervical cancer.
This means that we now have excellent data that many women can safely screen for cervical cancer without getting a pap smear. This is largely because nearly all cervical cancers are caused by a virus called HPV. Instead of getting a pap smear we now focus on detecting this virus. Of note, there is a vaccine against HPV that can prevent various forms of cancer.
After years of extensive research there is excellent evidence that detecting this virus is an accurate way to detect cervical cancer or precancer. For years, providers have already been using tests to detect HPV. These tests have helped providers predict who is at risk of developing cervical cancer. However, now you can check for HPV by yourself.
On their website, the American Cancer Society states that “Self-collection for HPV has been studied by researchers and screening programs around the world. Research shows the test is just as accurate as a sample taken in the office by a health care provider.”
In addition, a draft recommendation from the United States Preventative Service Task Force states that for patients 30 years or older the primary recommended screening tool for cervical cancer screening is HPV swab collected by either a patient or a provider. The pap smear is now an alternative form of screening. The draft statement by the USPSTF recommends a self-swab only once every five years.
Not everyone should do a self-swab to check for cervical cancer. In order to qualify, you must meet four criteria. 1. You must be 30 years or older. 2. You must have a cervix. 3. You must be asymptomatic, or in other words have no symptoms of cervical cancer such as irregular bleeding. 4. It must be your first screen, OR previous pap smears must have been normal OR have a remote history of an abnormal result that has a sufficient amount of follow-up and normal subsequent testing. You also should not self-swab if you have any of the following: Solid organ or stem cell transplant, HIV infection, taking medicines that suppress the immune system, or exposure to DES before birth.
What if you are under 30? Then you should have a PAP smear every three years, without HPV testing, starting at age 21. This may also change as further studies are conducted.
This test is ideal for woman who are victims of sexual assault, who have chronic pelvic pain or other reasons for the which a pap smear is difficult or uncomfortable. Because of this, I am very excited for the change in recommendations. I think many cases of cancer will be prevented or quickly treated before it spreads. Many women will be screened that would not have been screened. I’m excited for all the suffering it will prevent. So, if you’re due for cervical cancer screening and you are 30 or over, now is the time. It has never been easier.
– Dr. Daniel Sterner, DO is a provider at Health West American Falls. He specializes in family medicine and obstetrical care and is accepting new patients.
