Total prevention: testing and vaccination

Does the HPV vaccine protect me from cervical cancer? | Does the HPV vaccine mean I don’t have to be tested? | What is cervical cancer testing? | What is a Pap test? | What is an HPV test? | Which test do I get, and when? | Why two tests for women aged 30 and older | What happens after my test results

Does the HPV vaccine protect me from cervical cancer?

The HPV vaccine protects against the two HPV types that cause about 70% of cervical cancer. It is approved for girls and young women ages 9 through 26 but is recommended specifically for girls ages 11 and 12. (Researchers are now finding out if the vaccine works for women older than 26 years of age – but it’s not yet approved for older women.) Many girls and young women are getting the 3 shots over a 6-month period needed for vaccination. That’s very good news.

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Does the HPV vaccine mean I don’t have to be tested?

No. You still have to get tested.

Since the vaccine only protects against two HPV types, it doesn’t protect you from the remaining 30% of cases. Also, because the vaccine hasn’t been around for a long time (it was approved for use in 2006), we don’t know yet if vaccinated women will need booster shots later in their lives.

There’s more. The HPV vaccine doesn’t protect against the two HPV types if they’re already in your system. You’re protected only if you are immunized before you get infected through sex. That’s why the earlier you get the vaccine, the better chance you have of being protected.

Our tip to you: We’re giant fans of the HPV vaccine. But even with the vaccine on board, you have to get tested as if the vaccine didn’t exist.

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What is cervical cancer testing?

Cervical cancer testing uses samples of cells taken from your cervix during your gynecological exam. (Collecting cells from your cervix only takes a few seconds and, though not comfortable, generally isn’t painful at all.) There are two types of tests for the cells: a Pap test and an HPV test. Both kinds of tests are approved by the Federal Drug Administration (FDA).

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What is a Pap test?

A Pap test looks at your cervical cells under a microscope. A laboratory looks for any abnormal cells that could lead to cervical cancer.

The Pap test has helped decrease the number of American women with cervical cancer by about 75% in the past 50 years.

Possible Pap test results are

  • Normal Pap result: The lab didn’t find any abnormal cells.
  • Unclear or inconclusive Pap result: The cells don’t look clearly abnormal, but they don’t look clearly normal either.
  • Abnormal Pap result: The lab found cell changes. The results are ranked by number of abnormal cells found.
    • CIN 1: mild – about 60% of CIN 1 cases go away on their own
    • CIN 2: moderate
    • CIN 3: severe

      Most healthcare providers combine the moderate and severe categories: CIN 2/3.

      If you have results that are CIN 2, CIN 3, or CIN 2/3, usually your healthcare provider will directly treat these abnormal cells. See Abnormal cells: get them treated.

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What is an HPV test?

An HPV test looks for HPV in your cervix. It’s an early warning system. If the test finds HPV, you might not have any abnormal cells now. But the HPV could stick around and create abnormal cells in the future.

Possible results are:

  • Negative HPV result: You do not have HPV. You are at extremely low risk of developing cervical cancer within the next few years.
  • Positive HPV result: You have an HPV type that can potentially lead to cervical cancer. But don’t panic. This does not necessarily mean you have cervical cancer. It means you and your healthcare provider will be keeping a close eye on your cervix. Read about it at What happens after my test results?

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Which test do I get, and when?

Leading medical organizations set these guidelines for healthcare providers and insurers:

  • Begin getting Pap tests within three years of becoming sexually active or at age 21 – whichever comes first.

    After your first Pap, get a Pap test every year until you reach the age of 30.

  • When you reach 30, get the HPV test and the Pap test.

    From now on, get the HPV test and the Pap test every 3 years.

If your Pap or HPV test ever has unusual results, your testing schedule changes. Read about it at What happens after my test results?

Our tip for you: Because HPV testing is relatively new, some healthcare providers may not automatically do the HPV test. If you are 30 or older, tell your healthcare provider you want the HPV test along with your Pap. If you need to back up your case, give your healthcare provider this link to professional guidelines: www.thehpvtest.com/hcp/Resource-Center/Medical-Guidelines.html

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Why two tests for women aged 30 and older?

Women under age 30 often have HPV infections that go away on their own. Taking an HPV test would just sound unnecessary alarms. The Pap test alone is enough.

But from age 30 on, if women have HPV, the infection is far more likely to be a persistent HPV infection. Like a bad houseguest, the infection just doesn’t go away. By lingering in the cervix, the infection can cause abnormal cells leading to cancer. This graphic tells the story.

When you’re 30 and older, it’s best to combine the HPV test with the Pap test. Together, the tests detect problems – with up to 100% accuracy.

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What happens after my test results?

Depending on your age and your Pap and HPV test results, leading medical organizations recommend these steps:

  If you are under 30 If you are 30 or older
    HPV test is negative HPV test is positive
normal Pap Repeat the Pap test in 1 year Repeat the Pap and HPV tests in 3 years Repeat the Pap and HPV tests in 1 year.

If you get the same results 1 year later, then get a colposcopy and perhaps a biopsy

unclear or inconclusive Pap (also referred to as ASC-US Pap) One or more of the following:
  • If you’re 21 or older, get an HPV test
  • If you’re 20 or younger, repeat Pap test in one year
Repeat the Pap test in one year Get a colposcopy and perhaps a biopsy
abnormal Pap Get a colposcopy and perhaps a biopsy Get a colposcopy and perhaps a biopsy Get a colposcopy and perhaps a biopsy

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Tamika & Friends is supported by an unrestricted educational grant from QIAGEN.