Pap smears are an effective method for detecting cervical cancer in an early stage or even in a "pre-cancerous" stage. This early detection allows early treatment and a very high cure rate. The majority of cases of "uncurable" cervical cancer are in women who did not get regular Pap smears.

All women starting at the onset of sexual activity or age 21, whichever is earliest. They may be discontinued at age 70 if recent Paps have been normal. Paps are also not necessary after a hysterectomy for benign disease (not cancer).

During a pelvic exam, the physician uses a brush and a plastic paddle to scrape cells off of the cervix (the bottom end of the uterus). At the lab, the cells are stained and examined by a trained technician. Abnormal cells are examined further by a pathologist. Changes in the cells can indicate inflamation, infection, dysplasia (pre-cancerous changes), or cancer.

Pap Smears should be done at 1-3 year intervals. The 3 year interval can be used for low-risk patients who have had 2-3 consecutive normal Paps. However, the remainder of the pelvic exam (as well as breast exam) is still recommended yearly. Therefore, most physicians still do yearly Paps.

Most abnormal Paps only indicate inflamation, not cancer. This includes the most common abnormality, ASCUS (Atypical Squamaous Cells of Undetermined Significance). In the US, 2 million women have an ASCUS pap each year. ASCUS Pap smears are usually repeated in 3-4 months. Sometimes the followup Pap includes a test for a viral infection, HPV, which can cause cervical cancer. More severe abnormalities on Paps are evaluated further by Colposcopy. This is a special type of office biopsy in which the physician examines the cervix under a "microscope" and biopsies any suspicious-appearing areas.

Two ways: by having regular Pap smears and by avoiding the risk factors for cevical cancer. The risk factors are more than 2 sexual partners in lifetime, onset of sexual activity before age 18, cigarette smoking, past infection with a sexually transmitted disease (STD), poor nutrition, immune deficiency, HPV infection (see below), and a high-risk male sexual partner (one who has had multiple sexual partners, an STD, or a prior female sexual partner who had cervical cancer).

HPV, or Human Papilloma Virus, is a virus that is believed to cause most cases of cervical cancer. HPV is acquired by having sex with an infected partner. HPV can be carried by a man or a woman without causing any symptoms, or it can cause the growth of genital warts. There are many subtypes of HPV, but only a few of them cause cervical cancer. The specific type can be identified by HPV testing of the Pap Smear specimen. Most women who have had HPV will NOT get cervical cancer. HPV infection can continue lifelong, but most women will clear the infection in 3 years. There is no effective medical treatment for HPV infection, though genital warts can be removed by freezing, burning, laser, acid, or surgery.

First, don't panic. You should have regular Pap smears according to your doctor's recommendation. If you have a long-standing sexual partner, starting to use condoms is not helpful since they are likely already infected or are immune. Condoms are of some value if you have a new partner, but they are not completely effective since the HPV infection may reside in the skin around the genital area (which is not covered by the condom). In any event, you should discuss this with your new partner before starting sexual activity.

Cervical cancer is treated effectively by freezing, burning, or cutting the cervix, or by hysterectomy. Hysterectomy is usually resrved for patients who do not desire any more pregnancies and who have required repeated treatments of the cervix.