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Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Cervical Cancer Screening

Overview

Cervical cancer is a type of cancer that affects the cervix, which is the lowest, narrowest part of the uterus. Most of the time, cervical cancer does not cause any symptoms. It is diagnosed only by an abnormal result from a Pap test. Although it can be a serious cancer, you can take steps to prevent it.

A Pap test (also called a Pap smear) is a screening test for cervical cancer. Screening tests usually do not tell us for certain whether there is something wrong, but they do help us determine whether any further testing is necessary and when you should next be screened.

During the test, we check for abnormal cells in your cervix. Depending on what your Pap test shows, we sometimes need to do additional testing. Other times, we just recommend repeating your Pap test sooner than 3 years because mild changes usually go away by themselves over time. In most cases, we can detect precancerous changes years before they turn into cancer and, through simple office treatments, can completely prevent invasive cervical cancer from ever developing. 

If you notice unusual pain, bleeding, or vaginal discharge, you should make an appointment to see us for a checkup.

The uterus is shaped like an upside-down pear; the narrowest, lowest part is the cervix, which separates the uterus from the vaginal canal. During a Pap test, we will collect cervical cells and check them for cancerous and precancerous changes.


When to Schedule

We used to think that women should get a Pap test every year. However, the latest research indicates that the frequency of Pap tests depends on your age and health status. All women should get Pap smears every 3 years starting at age 21, and most women can stop having Pap tests at age 65.

Women under 25

Annual Pap tests are not necessary because cervical cancer is extremely rare in women under age 25, and cervical cells become cancerous very slowly. If your Pap smear is normal, you can safely wait 3 years for your next Pap test. If the Pap test is not normal, we sometimes recommend additional testing for more serious changes. However, because mild changes in the Pap smear are so common and often go away without treatment, we usually just recommend repeating a Pap test in 1 year. 

Women 25 and over

After you turn 25, you should continue to have Pap tests every 3 years and also begin to be tested for human papillomavirus (HPV). If your HPV test is positive, it does not mean that you have, or ever will have, cervical cancer, but we will want to follow up with you more frequently. We can discuss how often you should come in for a checkup after we get the results of your test. 

You can stop having a Pap test if any of the following are true:

  • You are over 65 and have had at least 3 normal Pap tests in the past 10 years.
  • You are over 65 and have had a negative HPV test and a normal Pap test.
  • You have had a total hysterectomy (your cervix was removed), and you have no history of cancer of the cervix, vulva, or vagina. 
  • You have no history of being treated for high-grade dysplasia (including cervical intraepithelial neoplasia 2 or 3) or adenocarcinoma in situ.

Before Your Pap Test

To get the best results, do not schedule this test during the time your next period is due. But if you get your period unexpectedly, come in anyway.

During the 48 hours before you come in:

  • Do not have intercourse.
  • Do not use vaginal medications or spermicide creams.
  • Do not douche or place anything in your vagina. 

How It Is Performed

The procedure is quick, and most patients do not experience any discomfort at all. A few women notice some mild cramping, like what they feel when they get their periods.

  • When you come in for your routine exam, we will use a small instrument called a speculum to gently spread the walls of the vagina. This allows us to see the cervix.
  • We will collect some of the cells from the cervix and send them to the lab to be checked for cancerous and precancerous changes. 

After the exam, you might notice a small amount of bloody discharge. This is normal.

Results

You can expect to hear from us in about 2 weeks with your Pap test results.

If the test results are normal:

  • You will receive a card in the mail or an online message.
  • You can safely wait 3 years until your next Pap test.

If the test shows abnormal cells:

  • We will contact you to arrange for follow-up exams.
  • This could mean repeating your Pap test sooner than every 3 years.
  • You may be asked to come back for a special procedure called a colposcopy. During this procedure, we use a magnifying instrument called a colposcope to look at your cervix in order to see if any areas look abnormal.

 

Risk Factors

We now know that most cases of cervical cancer are caused by a virus called the human papillomavirus (HPV). HPV is a common virus that can be passed from one partner to another during sex.

Most people carry the virus at some time in their lives, sometimes for a few months or a year or 2. There are many types of HPV, and most of them are harmless and will go away on their own. A few types of HPV can turn into cervical cancer, and a few types can cause genital warts.

The presence of HPV in anyone who has ever had sex is normal. Most women who have HPV will never get cervical cancer.

Risk Factors for HPV

Your health and lifestyle can determine whether you are at a higher or lower risk for contracting HPV.

Sexual history. You have a greater chance of getting HPV if you have had lots of sexual partners (or if your partner has had lots of sexual partners).

Cigarette smoking. If you use tobacco, one of the best things you can do for your health is to quit now. Smoking doubles the risk of cervical cancer in women who have HPV. Exposure to secondhand smoke may also be a contributing factor.

A weakened immune system. If you are HIV-positive, undergoing chemotherapy, or have an otherwise weakened immune system, you should take extra care to avoid HPV. You are more likely to catch HPV, and it is also more likely that your HPV will develop into cervical cancer.

Prevention

Cervical cancer is one of the most preventable cancers. To protect yourself, we recommend that you:

  • Undergo regular Pap tests.
  • If you smoke, stop. Contact us if you need help.
  • Practice safer sex.
  • Get the HPV vaccine if you are age 26 or younger.

The HPV Vaccine

In 2006, the Food and Drug Administration approved an HPV vaccine for girls and women from ages 9 to 26. The vaccine protects against the strains of HPV that may cause precancerous changes in the cervix and genital warts. 

  • The vaccine is given in 3 doses.
  • It works best when it is given to girls before they become sexually active (usually ages 9 to 12).
  • Girls and young women between ages 13 and 26 may also consider the vaccine.
  • The vaccine likely will not benefit women who have had more than 4 sexual partners in their lifetime.

We can talk about whether the vaccine is right for you at your next checkup.

If you have already had the HPV vaccine, you will still need to have a Pap test at least every 3 years. While the vaccine is effective against certain types of HPV, it does not prevent all the types that could possibly cause cervical cancer. It is also important to know that the HPV vaccine does not protect you against other sexually transmitted bacteria and viruses like chlamydia, herpes, or HIV.

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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.



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