So you've put off your Pap test again, why? It's like driving down the interstate doing 85 mph while not wearing your Seatbelt, it's so easy not to reach over, pull that seat belt over you and hear that comforting click. We know we shouldn't do it (not wear a seat belt), but somehow we still do. As you well know that type of avoidant behavior can be dangerous, there are thousands killed in auto accidents each year, many of which were not wearing their seatbelts. When we hear the news person tell us, "It is believed she wasn't wearing her seat belt", we look at each other with that knowing gaze, the question poised on our face. Why?
Why indeed? Don't we continually remind teenagers, loved ones, even ourselves, don't forget your seatbelt'! Putting off your Pap test can be an avoidant behavior similar to not wearing a seatbelt and nearly as dangerous. We know we shouldn't do it but somehow we still do. Approximately 20 million people or 15% of the U.S. population currently are infected with Human Papilloma Virus (1), a virus that is known to be attributable to cervical cancer. Not being medically screened for HPV puts you at risk for cervical cancer.
Read carefully: Approximately half of all cervical cancers occur in women who have never been screened (2). That is an amazing statistic! Do half of the people who have never been tested for HIV actually acquire HIV? No. At one time cervical cancer was responsible for more deaths in women than any other form of cancer! The advent of Pap screening has been the single most important factor in the dramatic decrease of mortality in women due to cervical cancer.
When should you get tested? Recommendations on scheduled screening from the US Preventive Service Task Force, the American College of Obstetricians and Gynecologists, and the American Cancer Society range from annually, to every 2-3 years. Several factors such as age of initial sexual activity (all recommend that girls get tested within 3 years of the onset of sexual activity), your current age, and results of prior tests all play a part in when it is recommended that a woman be screened for HPV. It is best to consult with your doctor as to when your next test should be and how frequently you should be tested; the important thing is to ask. If you have never been tested you should be tested as soon as possible.
A recent U.S. survey indicated that only 23% of women knew that HPV was a primary cause for cervical cancer, less than half of U.S. women were aware that HPV existed (3). Just as most people would probably prefer the protection of a seatbelt during an accident. Pap tests are a figurative seatbelt, they provide the opportunity of early identification and medical intervention for women facing the menace of HPV, and cervical cancer. If you have not been tested, or if it has been several years since you were last tested for HPV, pick up the phone, call your doctor or health clinic and make an appointment to do so! And remember to wear your seatbelt!

1. Cates W, Jr. Estimates of the incidence and prevalence of sexually transmitted diseases in the United States. American Social Health Association Panel. 1999

2. Hildesheim A, Herrero R, Castle P, et al. HPV co-factors related to the development of cervical cancer: results from a population-based study in Costa Rica. Br J Cancer. 2001

3. Association of Reproductive Health Professionals. HPV Survey Executive Summary. Available at www.ahrp.org/HPVsurvey/executivesummary.cfm