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When people are hesitant to ask questions, I am reminded of the African proverb- Not to know is bad, not to wish to know is worse. January is Cervical Cancer Awareness Month and this is the time I am reminded of the questions that I have been asked over the past year.

1. What is a pap smear? A pap smear is a screening test for cervical cancer. This means that it is a test to detect problems with the cervix before it becomes cancer. You cannot use a pap smear to give you a definite diagnosis of cancer. You will need additional testing if your pap smear is abnormal.

• What does it mean to have an abnormal pap smear? When your pap smear is abnormal, it means that the cells that were seen do not look normal.  You will need additional testing to get a better look at the cells. This may include having a repeat pap smear, having a colposcopy or having a procedure. To decide what needs to be done, will depend on your age, whether or not you are pregnant or whether or not you have had an abnormality in the past. Do not ignore an abnormal pap smear result. Talk with your health care provider and understand what needs to be done.

• Is there a way to prevent cervical cancer? YES, you can make sure that you get your pap smear when you are supposed to get it and get the human papillomavirus (HPV) vaccine. Use condoms if you are sexually active.

• If my child is not sexually active, do they still need the HPV vaccine? YES, the HPV vaccine is given to help prevent cervical cancer. It is better to get the vaccine before you are sexually active. The ideal time to get the vaccine is between ages 11 -12 years old, however it has recently been approved to get it up to age 45 year old. You can get the vaccine even if you have already had sex and even if you have been diagnosed with HPV. The current vaccine protects against 9 types of HPV so it can still protect you.

• Do you still need to have a pap smear even if you have had the HPV vaccine? YES, you still need to get your pap smear.

• Is a pelvic exam the same as a pap smear? No. A pelvic exam consists of three parts – checking your external genitalia– the vulva, putting a speculum into the vagina to look at the cervix and check the vagina and a bimanual to feel the internal organs – cervix, uterus and ovaries. The pap smear is one of many tests that can be done when the speculum is placed into the vagina. You can have a pelvic exam without having any test performed. A pelvic exam is not the same as a pap smear.

• Can I assume if I have not gotten the results of my pap smear, then it is normal? DO NOT ACCEPT NO NEWS IS GOOD NEWS. You should never make an assumption that any test is normal. When you have a pap smear performed, you should find out from your provider when to expect the results. You must always find out the results whether it is normal or abnormal.

• If I had a hysterectomy, do I still need a pap smear? It all depends on the type of hysterectomy, whether or not you have had an abnormal pap smear in the past, and the pathology of what was taken out during surgery. If you had a supracervical hysterectomy, meaning that your cervix was not removed, then you will need to get regular pap smear.

• When should you start to get a pap smear? You should get it starting at age 21 years old. There are exceptions. If you have tested positive for HIV, you might get it an earlier age.

1. At what age can I stop getting pap smears? It all depends. Most of the time it will be at age 65 years, however it will depend on your history. It will depend if you have had a history of pre-cancer of the cervix that led to treatment. It will depend if you have had at least two normal pap smears  with negative HPV testing in the 10 years prior to turning 65 years old.

For more information on Cervical Cancer Awareness Month, please click here. Remember that all insurance companies cover pap smears and the HPV vaccine (ages 9 – 26 years old). You can get a pap smear even if you do not have insurance. Click here for more information.