Your Guide to Cervical Cancer Prevention and Screening

January is Cervical Cancer Awareness Month

Cervical cancer is one of the most preventable cancers we have today. Routine screening finds pre cancer early, and the HPV vaccine helps prevent the HPV types most likely to cause cervical cancer. Because of these tools, cervical cancer rates have declined dramatically over the past several decades. Even so, in the United States each year, about 13,000 people are diagnosed and about 4,000 people die, most often when screening is missed or follow up is delayed.

At The Practice, our goal is simple: make prevention easy, make screening comfortable, and make follow up clear.

What is cervical cancer?

Cervical cancer develops in the cells of the cervix, the lower part of the uterus that connects to the vagina. In most cases it develops slowly over years, starting with precancerous cell changes. That is why screening works so well. We can catch changes early, often long before cancer develops.

HPV and why it matters

Nearly all cervical cancers are linked to persistent infection with high risk HPV types.
HPV is extremely common. Most sexually active people will be exposed at some point, and most infections clear on their own. The problem is not exposure, it is persistence over time. Persistent high risk HPV can lead to pre cancer, and in some cases, cancer.

Cervical cancer by the numbers

Each year in the United States:

• About 13,000 new cases are diagnosed
• About 4,000 deaths occur
• The highest burden falls on people who are overdue for screening or who could not complete recommended follow up

The HPV vaccine, Gardasil

The HPV vaccine is a cancer prevention vaccine. It protects against the HPV types responsible for most cervical cancers.

CDC recommendations include:

• Routine vaccination at ages 11 to 12, and it can start at age 9
• Catch up vaccination through age 26 if not adequately vaccinated
• Ages 27 to 45 may benefit in select situations through shared clinical decision making

If you are unsure whether you have received the vaccine series, we can review your history and help you decide what makes sense for you.

Cervical cancer screening, Pap tests and HPV tests

Start screening at age 21 (average risk).

Ages 21 to 29: Pap test every 3 years.

Ages 30 to 65: any of the following are acceptable:

• Primary high-risk HPV test every 5 years, or
• Pap every 3 years, or
• Co testing every 5 years

Stop after age 65 if adequate prior negative screening and no significant pre-cancer history (individualize).

Abnormal results should be managed using ASCCP risk-based guidance (follow up based on risk of CIN3+).

NCCN is the key reference for evaluation and treatment pathways when cancer is suspected or diagnosed (not routine screening intervals).

When can screening stop

Many patients can stop screening after age 65 if they have had adequate prior normal screening and no history of significant cervical pre-cancer. This should be individualized.

What to expect during a Pap test

A Pap test is usually quick. Many people feel pressure, a pinch sensation, or brief cramping. It should not feel sharply painful. If you have had a difficult experience in the past, tell us. There are many ways we can make it more comfortable.

How we make exams more comfortable at our practice

Comfort is not an afterthought; it is part of good care. Options include:

• Choosing the smallest speculum that still allows a good exam
• Using ample lubrication
• Slower pacing with step by step communication
• Warmed instruments when available
• Patient directed positioning, including support under hips or side lying options when appropriate
• Planning around bleeding when possible, although many people can still be screened while spotting
• Discussing pain and anxiety strategies ahead of time

If penetration or exams are painful for you, we can also talk about pelvic floor physical therapy, vulvo-vaginal health, and targeted treatment plans rather than forcing an exam that feels unbearable.

Abnormal Pap or HPV results, what they actually mean

An abnormal result does not mean cancer.

Most abnormalities reflect:

• HPV related changes that often resolve on their own
• Mild pre-cancer that can be monitored based on risk
• Changes that need a closer look to rule out higher grade pre-cancer

ASCCP guidelines use a risk-based approach to determine next steps, which may include repeat testing, colposcopy, or biopsy only when indicated.

The most important part is follow-up. We will clearly explain your results and your personalized timeline.

If cervical cancer is diagnosed

Cervical cancer is treatable, especially when found early. If cancer is suspected or diagnosed, care is guided by evidence-based pathways that include staging and tailored treatment planning. NCCN provides widely used clinical guidance for cervical cancer evaluation and management.
We coordinate prompt referral and guide you through each step.

Key takeaways

• Cervical cancer is highly preventable
• HPV is common, persistent high-risk HPV is the concern
• The HPV vaccine helps prevent cancers
• Screening saves lives, and most cancers occur when screening or follow up is missed
• Abnormal results are common and usually not cancer, and ASCCP risk-based guidance directs next steps

If you are overdue for screening, have questions about your HPV vaccine status, or need a gentler approach to exams, we are here to help.

References

1. American College of Obstetricians and Gynecologists. Updated Cervical Cancer Screening Guidelines. Practice Advisory. April 12, 2021.
2. American College of Obstetricians and Gynecologists. Cervical Cancer Screening. Patient infographic.
3. American Society for Colposcopy and Cervical Pathology. 2019 Risk Based Management Consensus Guidelines.
4. Centers for Disease Control and Prevention. Cervical Cancer Statistics. June 10, 2025.
5. Centers for Disease Control and Prevention. HPV Vaccination Recommendations and Shared Clinical Decision Making (27 to 45).
6. National Comprehensive Cancer Network. NCCN Guidelines for Patients, Cervical Cancer, and NCCN Cervical Cancer Guidelines overview page.