According to data compiled by the Centers for Disease Control and Prevention (CDC), a significant portion of Texas women are not screened for cervical cancer.

While most women do undergo cervical cancer screenings as recommended, data shows that Texas women lag behind the national average, with 22.7 percent of women between the ages of 21 and 44 reporting they have not received a pap smear within the last three years. Those can be frightening numbers considering cervical cancer is the third most common cancer diagnosed in Texas women ages 20-39, and fifth in women ages 40-49, according to Texas Health and Human Services. Especially when you consider that cervical cancer is highly preventable with proper screening.

The Screening Schedule

According to the American Cancer Society, almost all cervical cancers are caused by an HPV (human papillomavirus) infection. HPV is a very common virus. The CDC estimates that about 80 million people are currently infected with HPV in the United States, and about 14 million people in the US get a new HPV infection every year. Most people will never know they have HPV because the body can usually fight the infection before any symptoms occur. But high-risk types of HPV (such as HPV 16 and HPV 18) can cause serious pre-cancers and cancers of the cervix.

The goal of cervical cancer screening is to find pre-cancers that are likely to progress to cancer and to remove or treat them before they do. Screening can also find cervical cancer at an early stage, when it is easier to treat.

The most common method for cervical cancer screenings is a Pap test, but most recently, the ACS added an HPV test as a recommended screening tool as well. Both tests require a small sample of cells from the cervix collected by a health care provider using a special, small tool to gently scrape or brush the cervix. The same set of cells is used for both tests.

The Pap test looks for changes in the cells that might be pre-cancer or cancer. The HPV test looks in the cells for infection by high-risk types of HPV that are most likely to cause pre-cancer or cancer.

For people aged 25 to 65 years, the preferred screening recommendation is to get a primary human papillomavirus (HPV) test every 5 years. A primary HPV test is an HPV test that is done by itself for screening. But because these HPV tests may not be widely available in the US yet, the guidelines also allow for a co-test every 5 years that combines an HPV test with a Pap test or a pap test alone every 3 years.

After age 65, the ACS says women who have had 10 years of regular screening with normal results no longer need cervical cancer screenings.

Understanding Your Risk

It’s always a good idea to speak with your health care provider about your individual risk for developing cervical cancer and the cervical screening guidelines that will offer you the best protection. It’s also best to bring up any changes or concerns you may have, which may change your screening needs.

You are at average risk if you don’t have any symptoms of cervical cancer and any of the following is true for you:

• It’s the first time you’re getting screened.
• Your results have been normal every time you’ve been screened before.
• You had an abnormal result checked and your healthcare provider told you that you could follow the screening schedule for people at average risk.   

You need to talk to your health care provider and follow different guidelines if either or both of these are true:

• You’ve had pre-cancer or cancer of the cervix in the past.
• You have a weakened immune system. This includes, for example, people who have human immunodeficiency virus (HIV) or had an organ transplant or stem cell transplant. It also includes people whose mothers took diethylstilbestrol (DES) when she was pregnant with them.

Additional risk factors include:

• Smoking.
• Using birth control pills for a long time (five or more years).
• Having given birth to three or more children.
• Having several sexual partners.

Signs and Symptoms

Typically symptoms of cervical cancer do not become apparent until the cancer becomes larger or grows into nearby tissue. Women with pre-cancers usually have no symptoms. When symptoms do become apparent, the most common symptoms are:

• Abnormal vaginal bleeding, such as bleeding after vaginal sex, bleeding after menopause, bleeding and spotting between periods, or having (menstrual) periods that are longer or heavier than usual. Bleeding after douching may also occur.
• An unusual discharge from the vagina - the discharge may contain some blood and may occur between your periods or after menopause.
• Pain during sex
• Pain in the pelvic region

More advanced symptoms can include:

• Swelling of the legs
• Problems urinating or having a bowel movement
• Blood in the urine

It’s important to remember that these signs and symptoms can also be caused by conditions other than cervical cancer, but if you have any of these symptoms, make an appointment to see your health care provider right away. Ignoring symptoms may allow the cancer to grow to a more advanced stage and lower your chance for successful treatment.

Getting the Treatment You Need

Under the Affordable Care Act (ACA), cervical cancer screenings — along with numerous other cancer screenings such as mammograms and prostate cancer screenings — are now provided at no cost for women with private health insurance, Medicaid or Medicare. Additionally, the ACA allows children to stay on their parents health insurance plans until age 26, meaning more young women have continuous health coverage and access to screenings.

If you don’t have a healthcare provider but it’s time for your cervical cancer screening, visit TexasHealth.org/Doctors to find a gynecologist, internal medicine physician or family medicine physician who can provide these potentially lifesaving tests.