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.

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Cervical Cancer Screening Saves Lives

Most of the time, cervical cancer does not cause any symptoms. But cervical cancer can be successfully prevented and treated if detected early with regular pap tests.


Cervical cancer screening (Pap test) identifies abnormal cells in the cervix. During testing, we rub off cells from your cervix to examine under a microscope. 

Early cervical cancer does not typically cause symptoms, so an abnormal Pap test result indicates to us that further testing may be needed. 

In general, we recommend you have:

  • A first cervical cancer screening at age 21
  • A Pap test every 3 years between ages 21 and 65 
  • A human papilloma virus (HPV) test beginning at age 25

You do not need a Pap test after age 65, unless you have had previous abnormal results.

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Why It Is Done

A Pap test identifies abnormal cells in the cervix. In the early stages, cervical cancer usually does not cause symptoms, so Pap test results help us:

  • Detect and prevent abnormal cells from becoming cancerous.
  • Diagnose cervical cancer early on to prevent aggressive cancer from developing.

Depending on your Pap test results, we may order additional medical tests. Mild changes usually go away without treatment, so we may closely monitor abnormal cells. 

In some cases, we may recommend repeating your Pap test sooner than 3 years.

When to Schedule

The frequency of Pap tests depends on your age and health status. 

Women under 25

All women should get a Pap test every 3 years starting at age 21. We no longer recommend yearly Pap tests because:

  • Cervical cancer is extremely rare in women under age 25.
  • Cervical cells become cancerous very slowly.

If your Pap test is normal, you may safely wait 3 years for your next test. 

If your Pap test is abnormal, we may recommend additional testing, especially for major changes in test results. 

Mild changes in Pap tests are common. Abnormal cells often go away without treatment. We may recommend that you have your next Pap test in 1 year instead of 3 years. 

Women 25 to 64 

After you reach 25, continue to have Pap tests every 3 years. We also recommend that you add the human papillomavirus (HPV) test to identify the infection that often causes cervical cancer. 

A positive HPV test does not mean that you have, or ever will have, cervical cancer. Not all types of HPV cause cervical cancer. If you test positive for HPV, we may want to monitor you more frequently. 

Women 65 and older: no Pap test needed

You may stop having a Pap test when:

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


A Pap test is considered safe. You may experience mild menstrual-like cramps and slight vaginal bleeding after the test.

HPV and risk of cervical cancer

Human papillomavirus is the leading cause of cervical cancer. We recommend that you have the HPV vaccine before age 26. It is most effective when given to a girl before she becomes sexually active, or between ages 9 and 12.

You must continue having regular Pap tests even after you get the HPV vaccine. The vaccine does not prevent all types of cervical cancer.

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How to Prepare

Try to schedule a Pap test when you are not having your period. However, keep your appointment even if you unexpectedly get your period.

During the 48 hours before you come in:

  • Avoid intercourse.
  • Avoid vaginal medications or spermicidal creams.
  • Avoid douching or placing anything in your vagina. 

What to Expect

A Pap test is quick, and most women do not experience any discomfort. You may feel mild cramping similar to menstrual cramps during and after the test. You might also notice a small amount of bloody discharge, which is normal.

During your routine exam, we use a small instrument called a speculum to gently spread the walls of the vagina so we can view the cervix.

We place a special brush in your cervix to collect cells. The cells are evaluated in a laboratory for cancerous and precancerous changes. 


Your results should come back within 2 to 3 weeks. 

If the test results are normal:

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

If the test shows abnormal cells:

  • We contact you to arrange for a follow-up exam.
  • You may need to repeat your Pap test sooner than 3 years.
  • You may be asked to return for a special procedure called a colposcopy. 

During a colposcopy, we use a magnifying instrument called a colposcope to look at your cervix to view any abnormal tissue.

False-Negative Results 

It is possible to receive normal test results when you actually do have abnormal cells (false-negative results). 

You are at risk of having false-negative results when:

  • Only a small number of abnormal cells are present in the cervix.
  • Too few cells are collected for laboratory evaluation.
  • Blood or inflamed cells make it difficult to see the abnormal cells.
If one Pap test is a false negative, the next Pap test should detect the abnormal cells. It may take years for abnormal cells to grow into cervical cancer.

Additional References:

Your Care with Me

If after we make a plan for treatment your symptoms concern you or are not improving, please contact me.

Contacting Me

You can connect with me in a variety of ways, depending on the situation and what is most convenient for you at the time. I am available online, by telephone, or in person.

For nonurgent questions or concerns, you can: 

  • Email me using this site. 
  • Book an appointment online to see me in person.

For immediate concerns, or you prefer to use the telephone:

  • Call our 24/7 Appointment and Advice line at 1-866-454-8855. Our advice nurses can give you immediate advice, and our telephone staff can send me a message or book an appointment for you.

If you are experiencing an emergency, call 911 or go to the nearest Emergency Room.

Coordinating Your Care

Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.

Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay current on your health status and to collaborate with each other as appropriate.

When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

If you come to an office visit
  • At the beginning of your visit, you will receive information about when you are due for your next test, screening, or immunization. We can discuss and schedule any preventive tests that you need. 
  • At the end of your visit, you may receive a document called the “After Visit Summary” that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed, or if you just want to recheck your vital signs and weight. You can also view it online under Past Visits.
  • To help you prepare for your visit, please see additional details under Office Visit. 
If I prescribe medications

We will work together to monitor and assess how your medications are working and make adjustments as needed. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.

If refills are needed in the future, you can:

  • Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
  • Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
If lab testing or imaging is needed

For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.

If I refer you to a specialist

My specialty colleagues are readily available to assist me if I need additional advice about your condition. In some cases, I may contact them during your visit, so we can discuss your care together. If we decide you need a specialty appointment after that discussion, we can often schedule it the same day or soon thereafter.

If you are due for preventive screenings or tests

As part of our commitment to prevention, additional members of our health care team may contact you to come in for a visit or test. We will contact you if you are overdue for cancer screenings or conditions which may require monitoring.

Convenient Resources for You

As your personal physician, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.

My Doctor Online is available 24/7 so that you can access and manage your care where and when it is most convenient. From my home page you can:

Manage your care securely
  • View and compose secure e-mail messages.
  • Manage your prescriptions and schedule appointments.
  • View your past visits and test results.
  • View your Preventive Services to see whether you are due for a routine screening or updated immunization.
Learn more about your condition
  • Read about causes, symptoms, treatments, and procedures.
  • Find interactive health tools, videos, and podcasts to help you manage your condition.
  • View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
  • Locate health education classes and support groups offered at our medical center.
  • Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
  • View your Preventive Services to see whether you are due for a routine screening or updated immunization.

Related Health Tools:

Prepare for Your Procedure

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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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