We’ve all heard the old proverb: An ounce of prevention is worth a pound of cure. Translated, it simply means catching health issues early is best. Many preventive services covered under your health plan help do just that.

Three preventive services for women covered by health insurance are the pap smear, pelvic exam and the human papillomavirus (HPV) test. Each looks for abnormal cells before they turn into a serious condition like cervical cancer.

What Is a Pap Smear?

The Pap smear  is a routine outpatient cervical cancer screening that women have been getting for decades. It’s recommended that women start getting Pap smears at 21 years old. Pap is short for Papanicolaou – the last name of the doctor who studied changes in cervical cells in the 1900s.

The Pap test looks for changes in the cervix that may lead to cancer. Routine Pap smears are encouraged to find cancer early when it’s easier to treat. During the short procedure, your doctor collects cells and mucus from your cervix and the surrounding areas. The samples are sent to a laboratory for review by a pathologist.

It may take a few weeks to get results back. Once the results do come back, your doctor will contact you to let you know if your Pap smear was normal or abnormal. If your results are normal, your doctor will likely recommend another test in three to five years.  

An abnormal Pap smear doesn’t mean you have cervical cancer. There are a number of reasons results can come back abnormal. Be sure to follow up with your doctor to learn more about next steps.

How to prepare for a Pap Smear
A few tips can help ensure nothing skews the results of your pap smear.

• Try not to schedule your Pap smear during your menstrual cycle.
• Do not have sex for two days before the test.
• Do not douche for two days before the test.
• Do not use birth control foams, jellies, tampons, vaginal creams or medicines for two days before the test.

What Is HPV?

For women 30 or older, the HPV test can be done at the same time as the Pap test. The human papillomavirus  is one of the leading causes of cervical cancer cases in the United States. There are many types of HPV, and it’s the most common sexually transmitted infection in the nation.

During an HPV test, your doctor checks the cervix for the HPV virus. The virus can cause abnormal cells, which could lead to cervical cancer. It’s not likely that you’ll know when cervix cells have changed. Having regular preventive exams can help your doctor identify abnormal cells before they develop into cancerous cells.

Doctors don’t always test for HPV when you have a Pap smear. Ask your doctor which tests are included in your routine Pap smear and when you’ll receive your test results.

What Is a Pelvic Exam?

Pelvic exams look for signs of disease in the pelvic area. Doctors use pelvic exams to check your:

• Cervix
• Fallopian tubes
• Ovaries
• Rectum
• Uterus
• Vulva

Remember, Pap smears and pelvic exams check for different things. They can be done separately or at the same time by an OB/GYN. Your routine pelvic exam is also covered by your health insurance.

What Is Cervical Cancer?

More than 13,000 new cases of cervical cancer will be diagnosed in the U.S. this year. About 4,600 women will die from it.

The Center for Disease Control and Prevention defines cancer as a disease in which cells in the body grow out of control. In this case, cells near the cervix grow out of control.

Cervical cancer starts in the cells lining the cervix, which is the lower, narrow end of a woman’s uterus. It is a preventable disease if women have routine screenings and receive HPV vaccines.  

The American Cancer Society suggests women have regular health screenings to detect pre-cancers and abnormal cells before they become cancerous. Tests like the Pap and HPV tests are proven methods that help doctors find abnormal cells.

Cervical Cancer Risk Factors
There are several factors that can boost a woman’s risk for cervical cancer.

HPV infection. Women carrying the human papillomavirus have a higher risk for developing cervical cancer. HPV infections are spread through sexual contact.

Not everyone infected with HPV will be harmed by the virus. A strong immune system can fight it off. Only a very small portion of women infected with HPV develop cervical cancer. In the United States, HPV causes about 37,800 cancer cases each year.  

Weak immune system. Immunosuppression increases the risk that HPV will lead to cervical cancer. When the immune system is weak, it’s difficult for the body to fight infections like HPV and other diseases. HIV and medicines that prevent organ rejection after a transplant can cause immunosuppression. 

DES exposure. Diethylstilbestrol (DES) is a synthetic form of the estrogen hormone. The drug was prescribed to women to prevent pregnancy complications between 1940 and 1971. DES was later linked to cancer of the cervix and vagina in a small group of women.

While the drug is no longer prescribed, the daughters of women exposed from 1940 to 1971 have an increased risk of developing a rare form of cancer.

Women with HPV

There are other risk factors for women who already carry the HPV virus. Women with the HPV virus increase their risk for cervical cancer if they have seven or more full-term pregnancies, smoke or use oral contraceptives for long periods of time.

Can Cervical Cancer Be Prevented?

The National Cancer Institute lists several precautions women can take to lower their risk for cervical cancer. The type of HPV that leads to cervical cancer is transmitted through sexual contact. Women lower their chances of getting HPV when they:

• Get the HPV vaccine
• Use a condom or diaphragm

By now it should be clear why having a routine Pap smear, pelvic exam and HPV test is important. Early detection screenings are key to helping you staying healthy.

Sources: Key Statistics for Cervical Cancer,  American Cancer Society, 2024; Cervical Cancer,  Centers for Disease Control and Prevention, 2023; Pelvic Exam,  WebMD, 2022; Abnormal Pap Tests,  Center for Your Woman’s Health, 2021; Screening for Cervical Cancer,  CDC, 2023; Basic Information about HPV and Cancer,  CDC, 2024; Cancers Linked With HPV Each Year,  CDC, 2024; HPV Vaccination,  CDC, 2024

 Originally published 4/28/2016; Revised 2019, 2021, 2022, 2023, 2024