Regular Pap Smears Help Ensure Women's Health

By Levi Downs, M.D.
Jan. 20, 2006

During the past 50 years, the rate of cervical cancer among Western women has dropped dramatically. Most of the decrease can be attributed to the creation of the Pap test or Pap smear, in which a health-care provider collects a sample from a woman’s cervix—the lowest portion of her uterus—to detect for abnormal cells.

There is no better way to ensure cervical health than to receive regular Pap smears. Avoiding unprotected sex and having monogamous relationships also are important.  That’s because a sexually transmitted disease called the human papillomavirus (HPV) causes cancer of the cervix, as well as genital warts.

HPV can trigger the growth of abnormal cells on the cervix, also called cervical dysplasia. Left untreated, these abnormal cells can evolve into cervical cancer. Smoking is another risk factor for cervical cancer because it can significantly reduce a woman’s ability to clear human papillomavirus from her body.

For a woman who has abnormal cells on her cervix, her doctor will typically perform a large biopsy. This is a minor procedure that can be done in the doctor’s office. If the abnormal cells are deep within her cervix, the doctor might need to perform a cone biopsy in the operating room. And on very rare occasions, if a number of abnormal cells are discovered in the biopsy, the patient might have a hysterectomy, where her uterus and cervix are removed. 

While the Pap smear has been very effective in reducing cervical cancer, the medical profession isn’t resting on its success. Researchers are working hard to develop new ways to prevent cervical cancer. By the end of the decade, two new vaccines should be available to help women’s bodies tame the human papillomavirus.

One vaccine will be most effective for people who haven’t been exposed to HPV through sexual activity; it will be administered to girls between the ages of 8 and 11. The vaccine, which will be available later this year or in 2007, will stimulate the body’s ability to reject certain forms of HPV that are most associated with cervical cancer.

Another vaccine under development will be given to treat women who have abnormal cells on their cervixes. It will help decrease the development of the disease and encourage patients’ bodies to fight cells infected with HPV. However, this vaccine probably won’t be on the market for three to five years.

Until the vaccines are available, the most important thing women can do to promote good cervical health is to get a Pap smear every year. Women should begin receiving Pap smears within three years of starting sexual intercourse or when they turn 21. Those who are at low risk for cervical cancer, meaning they have had three normal Pap smears and don’t have multiple sexual partners, can space out their Pap schedules to every other or every three years.

Levi Downs, M.D., is an assistant professor of obstetrics and gynecology in the Division of Gynecologic Oncology at the University of Minnesota Medical School. He sees patients through University of Minnesota Physicians. This column is an educational service of the University of Minnesota. Advice presented should not take the place of an examination by a health-care professional. For more health-related information, go to http://www.healthtalk.umn.edu.