About 13,000 American women are diagnosed with cervical cancer annually. But the disease can often be prevented through early detection and treatment.

Traditionally, physicians have used the Pap test for early detection. Now there is an HPV test that can be used in conjunction with the Pap starting at age 30 as well as in any woman whose Pap test indicates abnormal cell changes. Pap smears pinpoint abnormal or precancerous cells caused by the HPV virus while the HPV test detects high-risk types of HPV typically found in cervical cancer. 

HPV is a very common virus. Researchers estimate that at least three-quarters of American women contract some form of the virus – there are about 100 types – in their lives. Some types of HPV cause only mild genital warts while about 13 high-risk types can lead to cervical cancer. 

HPV infections are extremely common in women under age 30 and usually go away on their own before causing problems. For this reason, physicians do not routinely test young women for HPV. 

Cervical cancer is most common in women ages 30 to 65, as HPV infections are more likely to be persistent. A woman with a persistent HPV infection is at greater risk of developing cervical cancer.

At The OB/GYN Specialists, we use the FDA-approved Digene® HPV test and follow the American College of Obstetricians and Gynecologists (ACOG) guidelines to test all women ages 30 to 65 with the Pap test plus the HPV test, a process called co-testing. The HPV test can be performed on the same sample of cells collected for the Pap test, so women can get both tests during their routine pelvic exams. 

Many women who have passed their childbearing years stop having routine gynecological exams and regular Pap tests. I do not recommend this approach. If a woman is not tested regularly, she will not know whether she has abnormal cell changes or HPV. Most insurance plans cover co-testing in women ages 30 to 65, so this need not be a barrier.

By co-testing, I was recently able to pinpoint cell abnormalities that went undetected previously in two normal Pap smears in a 36-year-old patient. Both Pap tests came back normal. However, the HPV test results were positive. This woman is now being evaluated for adenocarcinoma in situ or adenocarcinoma of the cervix. Adenocarcinoma is a tumor that develops in glandular tissue. In the case of cervical cancer, an adenocarcinoma can develop in the glandular lining of the endocervical canal, the narrow passageway that connects the cervix to the uterus. Cancer in this canal is often difficult to diagnosis by Pap smear alone. 

Cervical cancer is preventable. Early detection of abnormal cell changes is important. And co-testing can help.