Dear Alice,

Does a virgin need to have a Pap smear? Is cervical cancer the only disease a Pap smear detects? What are the means of contracting cervical cancer and any other possible diseases detected by the Pap smear?

— New at this

Dear New at this,

Keeping up with the different health recommendations can certainly be confusing, so it's great that you're being proactive about your preventive care! The Papanicolaou test (a.k.a.. Pap test or Pap smear) is used to detect cell changes or abnormal cells on a woman's cervix that may become precancerous or cancerous (the test may also be used to detect non-cancerous changes, too). Previously, it was recommended that women begin getting Pap tests three years after becoming sexually active or by the age of 21, whichever came first. However, the United States Preventive Services Task Force (USPSTF) recently updated the recommendations, which make no mention of previous sexual history. The change in recommendations was due to the finding that young women under the age of 21 were less likely to be diagnosed with cervical cancer and that if abnormal cervical cells were present, they were more likely to resolve on their own.

You also ask about how a person contracts cervical cancer. Folks don't actually catch cervical cancer: current research points to certain high-risk strains of the human papillomavirus (HPV) as the main cause of cervical cancer. HPV is typically transmitted through skin-to-skin contact. With that in mind, the Pap test is certainly a useful initial tool to identify and work toward preventing the development of cervical cancer.

New at this, if you've never been to a gynecologist before (a women's health care specialist), you may be interested in some further reading with Gynecologist for the first time? to learn more about what to expect not only with a Pap test, but also pelvic exam (which is normally paired with the Pap test) and regular women's health check-up. As far as results of a Pap test are concerned, a 'negative' result is also described as 'normal', meaning no abnormal cells were detected. In the event that abnormal cells are found, additional testing may be recommended to further investigate the finding, which (depending on the specific abnormal result) may include an HPV test. Though HPV is the most common cause of cervical cancer, testing positive for HPV doesn't necessarily mean that cancer will develop — it can take years for abnormal cells to develop into cervical cancer. The good news is that in some cases, the immune system will fight HPV and the abnormal cells will resolve on their own. A positive HPV test following an abnormal Pap test may result in further monitoring of the cells (i.e., more frequent Pap tests) and a specific treatment plan. The Go Ask Alice! Q&A Positive for high-risk HPV has even more information on interpreting positive HPV test results and next steps.

No matter your sexual history, though, speaking with a women's health care specialist will help you determine if it's the right time to start getting a Pap test and help answer any other questions you might have about your sexual health. You may also ask her/him about getting the HPV vaccine, which typically provides the most protection against the strains of HPV that typically cause cervical cancer when you are vaccinated before becoming sexually active. Want to learn even more about this topic? Consider chatting with a health promotion professional to get more information. You might also be interested in browsing the Women's Sexual Health category in the Go Ask Alice! archives.

Alice!

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