Healthy Aging

Cervical Cancer Screenings After 30-the Latest Guidelines

Are you wondering if you still need an annual pap smear as you age? Cervical cancer screenings are an important component of women’s health even in midlife. They aid in the prevention and early diagnosis of cervical cancers. 

Cervical cancer is a type of female cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina. It is the fourth most common type of cancer for women worldwide but also one of the most preventable.

Cervical cancer occurs most often in midlife and is most frequently diagnosed in women between 35 and 44 years of age. However, Research shows that almost one out of every five new cervical cancer cases between 2009-2018 was in women 65 or older. Many of these were late-stage cancers.

Causes of Cervical Cancer

The majority of cervical cancers are caused by Human Papilloma Virus or HPV. About half of all sexually active women will contract HPV at some point in their lives. Most people exposed to HPV won’t develop cancer. About ten percent of people exposed to HPV will develop long-lasting infections that put them at greater risk of developing precancerous lesions or cancer. Significantly fewer will do so.

There are more than 40 known HPV variants, 13 of which can trigger healthy cervical cells to abnormally replicate and mutate. Risk factors that can increase your risk of developing cervical cancer include:

  • Sexual Partners – The number of sexual partners you and/or your partner has will increase your odds of getting HPV.
  • Early Sexual Activity – Being sexually active at an early age increases the risk of HPV.
  • History of Sexually Transmitted Infections – STIs, including, chlamydia, gonorrhea, syphilis and HIV/AIDS, increases your risk of HPV.
  • Weakened immune system. If you have HPV and your immune system is weakened.
  • Smoking. Smoking is associated with squamous cell cervical cancer.
  • Exposure to miscarriage prevention drug. If your mother took a drug called diethylstilbestrol (DES) while pregnant in the 1950s, you may have an increased risk of a certain type of cervical cancer called clear cell adenocarcinoma.

Why is Cervical Cancer Screening Important?

Cervical cancer screening can identify infections, inflammation, precancerous cells, and cancers of the cervix. Identifying these conditions as early as possible gives you the greatest chance of avoiding or successfully treating cancer if you already have it. 

Research shows that regular screening decreases the incidence and mortality of cervical cancer by a whopping 80%. The screening tests are simple to perform and, although sometimes uncomfortable, relatively easy. It seems worth it for such impressive results. 

Do I Still Need to Screen for Cervical Cancer if I’m Not Having Sex?

Yes, you should have regular cervical cancer screenings even if you’re not having sex. Although it’s unlikely you’ll develop cervical cancer, it is not impossible. First, not all cervical cancers are caused by HPV. A minority are caused by run-of-the-mill DNA mutations. Also, HPV has occasionally been found in the vaginal canals of women who have never had penetrative sex. Non-penetrative sexual activity can transmit the virus, so even if you’re not having sex, you can become infected with HPV.     

Do I Still Need to Screen if I Got the HPV Vaccine? 

The HPV vaccine became available in the U.S. in 2006. If you’re young enough to have received it (it’s currently only recommended for those under 26 years old), keep in mind that you still need regular cervical cancer screenings. The HPV vaccine protects against most of the virus strains known to cause cancer, but not all. Also, if you were already sexually active before you got the vaccine, chances are you were already exposed to HPV. 

What Tests Are Performed?

Two tests can be performed to check for cervical cancer. The first is the Papanicolaou test, more commonly known as the Pap smear or Pap test. Your healthcare provider will collect cervical cells by using a speculum to open your vaginal canal and then swabbing your cervix. Those cells will then be checked for any abnormalities. 

The other available test is an HPV test. Cervical cells will be collected just like for a Pap test, but they will only be checked for the presence of HPV. This doesn’t show whether you have precancerous or cancerous cells, but it does show if you are at risk. 

You can also get a combined HPV and Pap test. This is called co-testing, and it is the most thorough cervical cancer screening available. 

How Often Should I Have Cervical Cancer Screenings?

For ages 21 to 65, healthcare providers generally recommend getting a Pap smear every three years. For women 30 to 65, the interval can be lengthened to every five years with a combined Pap smear and HPV test. If you have risk factors, talk to your healthcare provider for the best approach for you.

Over age 65? Read on for the guidelines for women 65+ and when it may make sense to stop screening for cervical cancer.

When Can I Stop Screening for Cervical Cancer? 

At age 65, if your last three Pap tests or last two Pap-HPV tests have been normal and there is no history of abnormal cervical cells or a more severe diagnosis in the last 25 years, and you have documented adequate negative prior screening in the ten-year period before age 65, the guidelines state that you no longer need regular cervical cancer screenings. 

Knowing that cervical cancer risk doesn’t magically vanish at age 65, you might want to discuss your medical history and risk factors with your healthcare provider and make a shared decision about testing. It might make sense for you to continue screenings after age 65. 

Only those who undergo a complete hysterectomy (removal of the uterus and cervix) no longer have any risk of cervical cancer, and testing is not necessary.  

Final Thoughts

Anyone with a cervix needs to keep in mind that cervical cancer is a possibility. Regular cervical cancer screenings can save your life by preventing cancer from ever forming or from finding cancers early when they are most treatable.

If you want to learn more about this topic, check out “What You Need to Know About Cervical Health” on the Midday app for more information on how you can keep yourself healthy. 

Jennifer Turkyilmaz, RN, BSN, is a medical writer who worked for many years in women’s health as a high-risk pregnancy nurse. She is also a newly menopausal woman who wishes she had known more about what to expect before it happened to her.

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