This screening includes a pelvic examination and a Pap Smear, two distinct but often combined procedures. In a pelvic examination, your healthcare provider will do a careful examination of your pelvic area. During the Pap Smear, some cells from your cervix will be gathered and sent to the laboratory for analysis. This same specimen or another similar one can also be used to do the HPV DNA test in some cases.

The pelvic examination is done to look for any abnormalities in the structures of the pelvic area and evidence of STD’s which can be further investigated if found.

The Pap Smear is done primarily to screen for precancerous changes or cancer of the cervix or vagina. On rare occasions, cancer of the ovaries or uterus could be detected with the Pap Smear.

A specimen may also be sent for the HPV DNA test; this test looks for evidence of infection with any of the 13 different strains of the HPV virus that may lead in certain individuals to cancer of the cervix. It may been done in women over 30 in conjunction with the Pap Smear or in any woman with an abnormal Pap Smear.

There is some difference of opinion in how frequently a Pap Smear is necessary. If a woman has 2 to 3 consecutive normal Pap Smears, then the test may be done only every 2 to 3 years after age 30 and not at all after age 65-70. There is some difference of opinion on how often to do a pelvic examination. Check with your doctor.

For women who became sexually active before age 18, testing should begin 3 years after first intercourse.

The pelvic exam includes a visual examination of the vulva, a speculum examination of the vagina and cervix, and a manual examination during which the doctor or nurse inserts one or two gloved fingers into the vagina and uses the other hand on the outer lower abdomen to examine the internal organs. A rectal examination is usually done also. The Pap Smear is done by scraping the cervix during the speculum exam and transferring the cells to a slide or a liquid and sending them to a special laboratory.

It is usually recommended not to schedule your examination during your period. Many doctors feel that the best time to have this examination is 5-20 days after the first day of your last period. You will probably be instructed to abstain from sex for 2 days prior to the exam and to avoid douching, tampons, vaginal creams, vaginal suppositories, vaginal medications, vaginal deodorants, and vaginal powders.

• Human Papilloma Virus (HPV) infection with certain strains
• Multiple sex partners, unprotected sex, early age first intercourse
• Smoking
• HIV infection
• Weakened immune system
• Previous cervical cancer
• Chlamydia infection
• Poor diet
• Age 50-55
• Daughter of woman who used diethylstilbestrol (DES) in pregnancy (risk is for clear cell adenocarcinoma of vagina or cervix)
• Oral contraceptive use >/= 5 years (maybe)
• Family history of cervical cancer in mother or sister