Regular Pap Tests May Detect Gynecologic Cancers

According to the CDC, an estimated 89,000 women in the United States are diagnosed with a gynecological cancer each year – ovarian, uterine, cervical, vulvar, vaginal, or tubal – and some 29,000 women die from the disease.

“At-risk women should talk with their doctors about the need for periodic, thorough pelvic exams,” says Paul Itam, MD, FACOG, a board-certified Obstetrics and Gynecology specialist at Kelsey-Seybold Clinic. “Women should start having pelvic exams and Pap tests by age 21, or within three years after having vaginal intercourse for the first time.”

Genetic cancer mutations, called oncogenes, can be acquired through smoking, aging, or environmental influences, or you can inherit these mutations from your parents or grandparents. Knowing your family history may increase your chance of early diagnosis and can help you take action toward prevention.

Sometimes, women who are past childbearing age assume they no longer need regular gynecological checkups and that younger women have a greater risk of developing a reproductive cancer. But often, the risk for these cancers increases with age. For example, the risk for ovarian cancer doesn't peak until a woman is in her late 70s.

Early ovarian cancer may not produce any noticeable symptoms. But if there is anything unusual, such as swelling of the stomach, pressure in the pelvis, or significant decrease in appetite, women should report it to a doctor right away. Also, any bleeding between menstrual cycles or after menopause could be early signs of endometrial cancer and require medical attention.

“Even if you feel well, you should see your gynecologist regularly for a well-woman checkup,” Dr. Itam says.

Although a Pap test doesn't detect ovarian cancer, it may detect cancer cells that have migrated to the uterine cervix from the ovaries or the presence of abnormal cells.

“Women who have had a hysterectomy to remove the uterus and cervix may not need annual testing,” Dr. Itam said. “But if the surgery was treatment for pre-cancerous cells or cancer, the woman should continue with annual screening.”

After age 65, women who have had at least three normal Pap tests with no abnormal results in the last 10 years may decide, after speaking with their doctor, to stop cervical cancer screening.

“Women should talk with their doctor about when to begin having Pap tests, how often to have them, and when they can stop having them,” Dr. Itam says. “Your OB/GYN can help determine an appropriate screening and prevention program based on your family’s history of cancer and other factors.”