Cervical Cancer - Diagnosis

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No test is 100% accurate, and it is possible for the Pap smear to miss the presence of cancer. However, if abnormal cells are missed on one test, they are likely to be spotted during the next one without a significant danger.

New tests and methods have been developed to improve the accuracy of the Pap smear in detecting cancer cells. For example, there are several computerized Pap test systems that are used to rescreen the original smear. These systems are either used to detect abnormal samples that may have been missed by manual review methods or are used in place of a human cytotechnologist. There is not yet enough evidence to know whether or not computerized methods are superior to conventional Pap testing.

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Newer, thin-layer liquid based tests (ThinPrep, SurePath) use the original cervical sample, which is rinsed in a special solution to thin the mucus (rather than dried). The fluid is examined for evidence of abnormal cells as well as HPV and other early abnormalities. Some studies have found liquid-based Pap tests to be more accurate than the standard Pap smear.

Current Pap Smear Screening Recommendations

General guidelines for cervical cancer screening recommend:

Initial Screening. Women should begin to undergo Pap tests at age 21 regardless of whether or not they have been sexually active.

Women Up to Age 30. Women ages 21 - 29 should be screened for cervical cancer once every 2 years with either a conventional or liquid-based Pap test.

Women Age 30 and Over. Women ages 30 and older should be screened for cervical cancer once every 2 years with either a conventional or liquid-based Pap test. Women in this age group who have received three consecutive negative (normal) annual Pap tests may be screened once every three years with either of these tests. Women who have certain risk factors (HIV-positive, weakened immune system, DES exposure, or prior cervical abnormalities) may need to be screened every year.

Elderly Women. Most women can stop cervical cancer screening around age 65 - 70, as long as they have had three negative (normal) Pap tests within the last 10 years.