Teal Health’s Take: It can be difficult to see cancer death rates everywhere we turn. The one positive about cervical cancer is that if detected early through routine screening, it is one of the most successfully treatable forms of cancer. But several barriers exist for routine screening. We are thankful to our community for sharing their stories and putting names to the numbers. We hope you find these inspiring and share the importance of cervical cancer screening with all the women in your life.

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When my results came back as irregular after a routine Pap smear in 2015, I wasn’t overly concerned. I had already been diagnosed with human papillomavirus (HPV) when I was 19, ten years prior. 

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But then my doctor ordered a colposcopy, in which they would take a biopsy from my cervix. I delayed this because it wasn’t made clear to me that this was an important follow-up, and like many young professionals, I had a busy life that I made the decision to prioritize; in hindsight, I wish I had understood the follow-up appointment should have been my priority. A few days after the colposcopy, my doctor called and asked me to come in for my results and to bring a support person along with me. For some reason, even that didn’t set off any alarm bells; I brought my boyfriend to the appointment and there, my doctor told me I had cervical cancer. 

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My cervical cancer diagnosis

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Looking back, there were a couple of symptoms indicative of cervical cancer. First, about two months before my diagnosis, I started feeling a lump inside my cervix. It wasn’t painful, just noticeable. Second, I started consistently bleeding after sex, beginning about a month before my diagnosis. Neither of these were warning signals to me and the diagnosis came from my routine Pap smear. 

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Fortunately, my cancer was in a stage classified as Stage 1B1 when I was initially staged and diagnosed, this is considered to have been caught early. After I underwent surgery to remove the tumor, a biopsy showed that the cancer had metastasized to my lymph nodes, but the staging for cervical cancer doesn’t change even if it has grown to affect other areas. 

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Because it was caught early, I never felt in real danger of dying. I just knew that having cancer and, subsequently, treating the disease, would upend my life for a while. 

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Treatment 

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Because of my stage, I was lucky enough not to require a full hysterectomy and instead was able to undergo what’s known as a radical trachelectomy, in which just a piece of the cervix is removed. In my case, this was about two inches.

Had my lymph nodes come back clean after the radical trachelectomy surgery, this would have been the end of my treatment. However, my doctor and I learned that the cancer had metastasized to two of the sixlymph nodes removed for biopsy. As I sat in his office while we received the results together, he began laying out a plan of care for my chemo and radiation regimen and connected me with a radiology oncologist. 

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Cervical cancer treatment and fertility preservation

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As a young woman dealing with a cancer diagnosis, I was the one who brought up the question of fertility because I was in my late 20s and knew I wanted to have children one day. Fortunately, because my cancer wasn’t highly aggressive, I was able to put off my chemo and radiation regimen to go through the 4-week process of IVF.  

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One important observation I had is that the doctor’s primary focus is to kill the cancer.

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As the patient, you can’t rely on them to think through every way your life and future will be impacted outside of curing the disease. This is why it’s important to do your own research, ask questions and advocate for yourself. 

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Though this is luckily changing in many parts of the US, at the time of my diagnosis fertility treatment and egg preservation were less common and not typically covered by insurance. These are quite cost-prohibitive procedures that can make it unrealistic for cancer patients to prioritize. In my research, I found that there are nonprofit organizations whose mission is to aid cancer patients with the monetary aspect of fertility treatment. These can be found through a quick Google search.

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Advocating for yourself throughout cervical cancer treatment

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While fertility preservation is one example, you absolutely need to take ownership and do your research so that you can be prepared and actively participate in your treatment plan. Second, if something doesn’t feel right, bring it up and don’t let it go until your concerns are adequately addressed. I’d also always recommend getting a second opinion; if for no other reason than to feel completely confident with your doctor before starting treatment. 

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Could my cancer diagnosis have been prevented? 

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Because of my HPV diagnosis at 19, I saw my doctor for annual Pap smears even though the guidelines for most people recommend one every three years. The results consistently came back as “irregular,” until one year they were regular, which I’ve now learned can happen even if you have a high-risk HPV strain. 

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Because of this “regular” result, my doctor at the time said I didn’t need a Pap smear for another three years. My next Pap smear, in June of 2015, was the one in which I was diagnosed with cervical cancer. The obstetrician who diagnosed me said it looked like a very slow-growing tumor that had probably developed over about three years—meaning my cancer could easily have been prevented had I continued with annual screenings. 

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Today, I’m living cancer-free, married, and expecting my first child. While a cancer diagnosis changed my life, surviving it has helped me see life for what it is and not stress nearly as much about the every day minutiae. You will get through this, but it’s going to be hard. You’re going to need to support yourself and you’re going to need a support system. You’ll come to appreciate the good news that you’re alive and no longer have cancer. 

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A note from Teal: Following a positive HPV test, it’s important to speak with your doctor to determine and understand your screening schedule moving forward. The type of test performed, along with your results, determines when you should screen again. 

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You may be aware that the cervical cancer screening guidelines have been updated in recent years. These updates reflect advances in women’s health and highlight how much we have learned and continue to learn about HPV. Most significantly, evidence shows that high-risk HPV causes more than 90 percent of cervical cancers. 

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We also know the primary HPV test (which is the test utilized by Teal Health) is a better (more sensitive) screen for cervical cancer. It was first incorporated into guidelines with a Pap smear (known as a co-test), and more recently as a stand-alone screening test (“primary” screen in some guidelines). For decades, Pap smears were recommended every 1-3 years, or more frequently if results were abnormal. With HPV testing, screening guidelines changed to every 5 years for a negative result. If you receive an abnormal result, this timeline may be adjusted and should be discussed with your provider.

Many of us get cervical cancer screenings (often just called your Pap smear, even though it may also include an HPV test) because our doctor recommends them, without much thought into the process. You may groan when you see the appointment on your calendar and probably cringe a bit when it’s time to put your feet in the stirrups. At Teal Health, we are working to make the process of cervical cancer screening less uncomfortable. Let's start by getting a better understanding of the exam itself, and why it’s so important.

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What is a cervical cancer screening? 

The cervical cancer screening experience – conducted in a clinic, using a speculum – has not evolved much in its 80 years in medicine. However, there have been updates to what doctors can test for. Thanks to major advancements in research and technology, we know human papillomavirus (HPV) is linked to nearly all cervical cancer diagnoses. These findings led to the introduction of the HPV test.

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Below are the three tests that can be performed during your cervical cancer screening exam:

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Primary HPV: This screening test looks for a current HPV infection. Detecting HPV is critical because having high-risk HPV is the single most important risk factor in developing cervical cancer, as almost all cervical cancers are caused by HPV.

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Pap Smear: According to Dr. Liz Swenson, Medical Director and OB-GYN at Teal Health, “A Pap smear is a screening method used to sample the cells of the cervix to test for changes which could indicate precancer or cancer of the cervix. Usually, this is due to an infection with a type of high-risk HPV.”   

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Co-test: A co-test includes both a high-risk HPV test and the Pap test. 

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It's good to understand which test you receive because the follow-up timelines can be different and these tests are looking for (slightly) different things. The tests also differ in their sensitivity (the test’s ability to pick up an infection or disease if it is present), with the HPV test being the most sensitive at above 94% overall. Since the Pap has a lower overall sensitivity, it could be a good idea to ask your clinician about getting a primary HPV or co-test.

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Following a normal HPV test, you won’t need to test again for up to five years (abnormal results for any test will result in more immediate follow-up with your doctor). If you have a Pap smear with normal results, you’ll need another one in three years. It is, however, important to review your individual situation with your provider and determine the most appropriate timing for your next screening.

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What does getting a cervical cancer screening entail?

We’ll speak plainly here: The traditional clinic-based cervical cancer screening is in dire need of an upgrade. Teal Health is currently working on an at-home self-collection option for primary HPV testing so that you can collect a cervical sample from the comfort of your own home. While we work towards FDA approval (and you can be the first to know by signing up here), here’s what you can expect when you go into the doctor’s office for a screening. 

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When you arrive at the doctor’s office, you’ll undress from the waist down and likely change into a gown. Your doctor or clinician will have you place your feet in stirrups and spread your legs. From there, they will use a speculum to hold the vaginal walls apart so the clinician can access your cervix. They will insert a cervical brush and you may feel pressure as they collect a sample. It’s not a comfortable process, but it shouldn’t take longer than a couple of minutes. 

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After your exam, your clinician will insert the brush into a preservation solution and send it to a lab with an order from the physician to perform a HPV test and/or Pap smear on the sample (depending on which test you got). Within 1-3 weeks, you’ll get results from your doctor, indicating either “normal” or “abnormal” results and the appropriate follow up. This could include doing additional testing if your results are abnormal.

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What exactly *is* my cervix? 

So, your doctor or clinician will access your cervix via your vagina during a cervical cancer screening (take a look at this diagram to learn more). But what exactly is the cervix?  Dr. Swenson explains, “The cervix is the lowest portion of the uterus which connects the uterus to the vagina. It produces mucus that cleans and hydrates the vagina. Because the cervix responds to hormonal changes, the character of the cervical mucus changes throughout the menstrual cycle.”

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Perhaps if you’ve tracked your menstrual cycles or tried to conceive, you’ve noticed or looked for changes in your cervical mucus. Dr. Swenson says, “Near the time of ovulation, the mucus is thin and slippery, promoting sperm to pass through. During pregnancy, it develops a protective thick mucus plug which helps prevent infections. The cervix is the part of the uterus that opens/dilates during labor, allowing the fetus to move through the birth canal during a vaginal delivery. It can also be a source of sexual stimulation for some women during intercourse.”

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What should I know before I get a cervical cancer screening?

Now that we know more about what to expect and why a cervical cancer screening is important, we asked Dr. Swenson if there’s anything else to know before getting one. 

She says, “Having sex just before your screening can cause some changes to show up on the cells, indicating inflammation or atypical cells of undetermined significance. The presence of HPV is used to determine the significance of these findings. If there is no HPV, it is most likely benign and nothing to worry about.” So while it may be best to avoid sex the day or so before your screening, Dr. Swenson says it’s fine to have sex as soon as you feel comfortable after your test results. 

Lastly, she explains that it’s common to have some spotting after a cervical cancer screening. 

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When and where should I get a cervical cancer screening? 

For now, the U.S. Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS) recommend getting an HPV or co-test (Pap + HPV) every 5 years, or a Pap smear every 3 years if you are between 25-65 years old (no younger than 21 years, according to the USPSTF). The ACS recommends HPV primary testing as the preferred screening method, if it’s available in your clinic. All insurance covers cervical cancer screening tests every three to five years, and most cover it every year.  

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“Cervical cancer screens can be done by a variety of providers, including OB-GYNs, midwives, family practitioners, internists, nurse practitioners, and physician assistants,” says Dr. Swenson. “It's helpful to confirm that your primary care provider [performs a Pap smear] as part of their routine exams, as occasionally some don't include this as part of their care.” 

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The future of cervical cancer screening is bright

If you haven’t had a Pap smear in the past three years or an HPV or co-test in the last five years, don’t wait to get screened. But a better way is on the horizon, and we’re so excited to share with you what we’ve been working on. 

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The Teal Wand^TM will enable people to perform self-collect primary HPV testing at home—no more uncomfortable speculum and stirrups at your doctor’s office. The Teal Wand^TM (think a swab similar to a tampon) will make screening more comfortable and accessible for everyone with a cervix. Sign up below to be the first to know when you can get Teal Health in your state. 

At Teal Health, we’re on a mission to get everyone with a cervix screened for cervical cancer. Despite the fact that cervical cancer is highly curable when caught early, one in four women in the U.S. has not had her screening. In this article, we’ll cover some of the most common reasons for this, as well as how we all can help overcome them. 

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1. Lack of information

One reason people do not get routinely screened for cervical cancer is simple: They aren’t aware that they should be. Whether it’s misinformation about what an HPV test orPap smear is for, lack of awareness about cervical cancer prevention, or not knowing the cervical cancer screening guidelines, we have a long way to go to make sure everyone has the information they need to make informed decisions about their cervical health. 

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According to Teal Health’s Medical Director and OB-GYN Liz Swenson, MD, “Education can start as early as middle or high school health classes. It would also be helpful to have more information on frequented media-based and social platforms like Instagram. Lastly, doctors should talk about HPV and cervical cancer screening during preventive exams and follow-up exams so as not to miss an opportunity to educate.” 

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While we can’t control how doctors manage their appointments or how teachers manage their curriculum, here are some ways we can all help get the word out about cervical cancer screening: 

• If you’re the parent of a school-aged child, ask your child’s health class teacher whether the curriculum will cover preventive screenings and tests for HPV and cervical cancer. If not, either share information (like this article!) with them, and/or educate your child. 
• Make sure you get the HPV vaccine, or get your child vaccinated against HPV based on medical recommendations. If you have a daughter, speak with her doctor about when she should begin screenings. 
• Ask your doctor(s) about preventative testing, not just for cervical cancer but for anything else you may not even know about! Doctors are busy but they’re here to help—sometimes you may just need to prompt them by asking the right question. 
• Spread the word. Whether it’s resharing statistics or information on social media or openly talking to your friends and family about your latest Pap smear, spreading the word can save lives.

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2. Lack of access (care deserts)

In over nine percent of all U.S. counties, the majority of residents live in an area with a primary care provider shortage. This means roughly 13 million people live in areas where they cannot easily access a doctor’s appointment at a physical location. Further, as of 2017 half of U.S. counties lack a single obstetrician-gynecologist (OB-GYN), and as recently as 2020, 36 percent of U.S. counties had no hospital or birth center offering obstetrics care.

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This lack of access to care can have devastating impacts on women. We saw the impact of lack of access to care during the pandemic—cervical cancer screening rates dropped by 94 percent in 2020. One way we can improve care deserts is by making virtual care and self-screen options far more accessible and available. 

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At Teal Health, we’re working to bring an at-home self-collection option for cervical cancer screening at no cost to the patient. This is a test that can be done in less than 5 minutes, from the comfort of your own home. We’re inspired by the efforts and innovations of other medical tech companies, all with accessibility and quality patient care at the forefront of their missions. 

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3. Lack of trust in medical institutions

According to self-reported data compiled by researchers for the Journal of General Internal Medicine, respondents reported a median score of 31 (within a range of 10 to 50) on the Health Care System Distrust scale, indicating generally high levels of distrust. These numbers are even higher among minority communities and people of color. When asked about their own healthcare experiences, 56 percent of Black Americans reported having at least one negative experience, including having to speak up to get proper care and/or being treated with less respect than other patients. 

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Again, improving access to virtual care is critical as it opens opportunities to find a provider the patient can trust, as opposed to being limited to the primary care physician physically closest to them. 

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4. Discomfort and fear of the speculum exam

According to Dr. Swenson, fear of the exam itself is a major reason women don’t get screened for cervical cancer. The speculum—the tool used for the Pap smear or standard clinic-based exam —hasn’t been updated in over 150 years. Needless to say, the device can appear intimidating to many women. Additionally, prior sexual trauma can make the process extremely uncomfortable and distressing for women.

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Teal Health data indicates that 87 percent of respondents would get screened on time if the Teal self-collection Wand^TM were available. Of the women who have tested Teal’s Wand^TM, 94 percent preferred it to clinician collect with a speculum. We are seeing that people overwhelmingly want the option to perform what has historically been such an intimate and uncomfortable exam from the comfort of their own homes.

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5. Fear of abnormal results

Of course, as with any medical exam, there is always the fear of abnormal or concerning test results. Dr. Swenson mentions the importance of removing the stigma of HPV and abnormal cervical cancer screening results, something we can again do by talking openly about our experiences with the women in our lives. 

While cervical cancer is a frightening diagnosis, when caught early it is curable 92 percent of the time. This is a highly curable type of cancer that can be eradicated if we ensure everyone with a cervix gets screened on time, every time. 

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Teal Health is working to bring you a comfortable self-collection option for cervical cancer screening that you can conveniently do in the privacy of your own home—sign up for our waitlist to be informed when we’re FDA-approved and available in your state. 

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October is Breast Cancer Awareness Month, and as your trusted experts in women's health, we thought it timely to inform you of some recent changes to critical women's health screening guidelines as of 2023.

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This year, the United States Preventive Services Task Force (USPSTF) announced new breast cancer screening recommendations. Importantly, they lowered the age at which women should start screening by 10 years—from 50 to 40 years old. The U.S. Food and Drug Administration (FDA) also now requires that patients are informed about the density of their breast tissue, which can impact how a mammogram is interpreted and increase their breast cancer risk.

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While you can always ask your doctor for the most up-to-date cancer screening recommendations, it’s important for women to have an idea of these timelines and guidelines for themselves too. Since they’re often changing based on the latest science and medical advancements, this can feel daunting. But don’t worry, Teal Health is here to help. 

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In this article, we’ll take a look at the latest screening recommendations for breast and cervical cancers so you can rest assured you’re on top of these important preventive measures. Note that these screening guidelines are for women with average risk factors for breast and cervical cancer. Those who have a relevant family history or may have a breast cancer-related genetic mutation may need to begin screening earlier and more frequently. You should always discuss your specific medical history with your doctor, should you need a personalized or tailored screening schedule.

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Breast cancer screening guidelines

Part of what makes screening guidelines potentially confusing is that various organizations make different recommendations. The reason the USPSTF’s updated recommendation of lowering the screening age from 50 to 40 is noteworthy is that it is now aligned with the American Cancer Society (ACS) and the National Comprehensive Cancer Network (NCCN). Therefore, all the major experts agree: Women should begin breast cancer screening at age 40. 

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In terms of how frequently you should get screened after your initial mammogram, the experts still differ. The ACS and NCCN state that women should get screened annually beginning at age 40, though the ACS says it should be “optional” for women ages 40-44 and mandatory from 45 onward. The USPSTF recommends women get screened every other year. In terms of what makes sense for you, talk to your doctor and come up with a plan you’re comfortable with. Weigh the pros (early detection) against the cons (like overdiagnosis or the potential for a false positive) and decide whether you’ll be screened annually or biennially. 

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As of 2023, the FDA also requires the facility conducting your mammogram to tell you about the density of your breasts. Dense breast tissue can make mammograms hard to interpret (so your provider may suggest other screening methods) and are also a risk factor for developing breast cancer.

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Most providers and the National Breast Cancer Foundation also recommend doing a breast self-exam on a regular basis (typically, once a month). Self-exams help you stay familiar with how your breasts feel, so you can notice any changes. You can start self-exams as early as your 20s and 30s. However, self-exams should not take the place of routine mammograms and clinician-conducted breast exams.

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What does breast cancer screening entail?

Breast cancer screening is usually done via a mammogram, which is an X-ray of the breast. You will place each breast between two plastic plates, and then a technician will take a quick X-ray. A screening mammogram will only take a few minutes, whereas a diagnostic mammogram (taken if you’ve noticed signs or symptoms of breast cancer) will be more involved. Other (less common) breast cancer screening approaches can involve an ultrasound or a breast MRI.

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Cervical cancer screening guidelines

As we mentioned, it can be confusing to stay up to date on all of your preventive cancer screenings. In 2018, the USPSTF made changes to cervical cancer screening guidelines. Then in 2023, the ACS released new guidelines. 

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For decades, a Pap smear was the best way to test for cervical cancer. Then, with the evidence that HPV (human papillomavirus)  causes more than 90 percent of cervical cancers, the HPV test was introduced alongside the Pap smear. Now, there are three ways to test for cervical cancer: a Pap smear, an HPV test, and a co-test, which includes both a Pap smear and HPV test. 

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The main difference between the Pap and HPV tests is that the HPV test catches changes in the cervix earlier than Pap tests. The Pap test finds changes in cervical cells after they’ve already happened. 

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Here are the most current screening schedules for cervical cancer, which include recommendations for Pap, HPV, and co-tests, according to each organization: 

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• U.S. Preventive Services Task Force: Recommends a Pap test every three years for women ages 21-29. For women over 30 years old, either a Pap test every three years, primary HPV testing alone every five years, or co-testing (Pap + HPV testing) every five years. 
• American Cancer Society: Those aged 25 to 65 should have a primary HPV test every 5 years. If primary HPV testing is not available, screening may be done with either a co-test that combines an HPV test with a Papanicolaou (Pap) test every 5 years or a Pap test alone every 3 years. 

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The main differences between the two are recommendations based by age as well as the ACS stating HPV as the preferred type of testing. 

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What does cervical cancer screening entail?

You’ll also notice that there are three types of cervical cancer screening tests mentioned in these recommendations. Some providers continue to perform Pap smears and HPV tests together (known as a co-test) every 5 years. However, as of 2020, the American Cancer Society’s preferred cervical cancer screening method for women ages 25-65 is the primary HPV test every 5 years (in place of the Pap smear) because it is a better (more sensitive) screening test for cervical cancer. Here are the current recommendations: 

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• The Primary HPV (human papillomavirus) test screens for a panel of high-risk HPV.  Having certain HPV types is the most important risk factor for developing cervical cancer – primary HPV screening can help prevent and catch cervical cancer early. 
• The Pap test or Pap Smear The Pap test or Pap Smear looks at cells collected from the surface of your cervix.  This process can detect early changes before cancer starts, but can also show harmless changes, sometimes triggering a false positive result.
• A co-test includes the primary HPV test & the Pap test, incorporating the benefits and risks of both. This method is the runner-up to primary HPV testing in its ability to detect risks for precancer changes. 

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The procedure for these tests will look and feel the same. When you arrive at the doctor’s office, you’ll undress from the waist down and likely change into a gown. Your doctor or clinician will have you place your feet in stirrups and spread your legs. From there, they will insert and open a speculum to hold the vaginal walls apart so the clinician can access your cervix. They will insert a brush to get cells from your cervix which may cause you to feel pressure or mild cramping. It’s not a comfortable process, but it shouldn’t take longer than a couple of minutes. 

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After your exam, your clinician will insert the brush into a preservation solution and send it to a lab to perform an HPV test and/or Pap smear on the sample. You’ll typically receive results from your doctor within 1-3 weeks. 

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Now that you’re up to date on breast and cervical cancer screening guidelines, don’t wait to get screened. As for the future of cervical cancer screenings? Teal Health is working to bring you a comfortable self-collection option for cervical cancer screening that you can conveniently do in the privacy of your own home—sign up for our waitlist to be informed when we’re FDA-approved and available in your state. 

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There’s a lot to understand when it comes to human papillomavirus (HPV)—as there are more than 200 different types. (Check out our guide for a more comprehensive overview.) Here, we’re diving into genital warts (or, HPV warts), which are skin growths that are sexually transmitted infections (STI) caused by certain types of HPV. 

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HPV warts: What they are and what causes them

As a quick refresher, HPV is a group of viruses, some of which are spread through vaginal, anal, or oral sex. Sexually transmitted HPV falls into low-risk and high-risk groups, and within these groups, there are different genotypes of HPV (those categorized as higher-risk are routinely screened for as part of your cervical cancer screening). There are about 40 types of HPV that are sexually transmitted and can affect your genital area.

Genital warts are usually caused by low-risk types of HPV, such as types 6 and 11. These are not the types of HPV that typically cause cancer, but they can cause warts on or around the genitals, anus, or throat. If you notice these warts, you should visit your doctor; however, it’s important to note that many HPV infections can be asymptomatic. 

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HPV warts occur in both men and women. In men, if the warts are large enough to be seen, you may notice them on the tip or shaft of the penis, the scrotum, or the anus. In women, genital warts may be visible on the vulva or between the external genitals and the anus. They may also occur inside the body; on the walls of the vagina or the anal canal. Warts can also occur in the mouth or throat of someone of either sex who has had oral sex with someone infected with HPV warts. 

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Symptoms of HPV warts

Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. The warts may go away, stay the same, or grow in size or number.

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According to Teal’s Medical Director, Elizabeth Swenson, MD, “Typically, these are painless growths that can be painful or cause bleeding if irritated. The less common symptoms occur typically when [the warts] aren't visible (they can occur within the vaginal canal) where they can cause bleeding and/or pain after intercourse. They can also itch and cause painful urination.”

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HPV warts and pregnancy

Worth noting is that HPV warts can cause complications during pregnancy. The Mayo Clinic warns that while rare, warts can enlarge during pregnancy, making it difficult to urinate and/or inhibiting the stretching of vaginal tissues during childbirth. Warts can bleed when stretched during delivery, and in extremely rare cases, a baby born to a mother with genital warts can develop the infection in their airway, which is known as respiratory papillomatosis. Dr. Swenson states, “This condition can cause airway obstruction and these children can require numerous surgeries to remove the growths from their airway.” 

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As with any complication you wish to avoid, it’s always best to raise concerns with your doctor and ensure they know your medical history with HPV warts should you become pregnant. 

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How to treat (and prevent) HPV warts

If you suspect you may have genital warts, your best bet is to speak to your healthcare provider. They may be able to prescribe topical medicine to use at home or remove the warts with treatments in the office. However, it's important to note that you may still be able to to pass along the infection even if you don't have visible symptoms. If left untreated, genital warts may go away, stay the same, or grow in size or number.

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In terms of prevention, Dr. Swenson advises, “Since genital warts are an HPV-related condition, the quadrivalent and nonavalent vaccinations are the best prevention available. Protected sex (using condoms) can help prevent them.” 

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Similarly, practicing safe sex is always wise when it comes to preventing STIs like genital warts. Avoid having sex with a partner who has active warts.

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The HPV vaccine

HPV vaccines were first introduced in the U.S. in 2006 and since then, among teen girls, infections with HPV types that cause most HPV cancers and genital warts have dropped 88 percent. The CDC also reports that among young adult women, these same infections have dropped 81 percent. 

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Gardasil, the HPV vaccine is recommended for everyone (both females & males) between ages 9-26. While it is recommended until 26, it is approved in the United Sates though the age of 45, it is worth asking your doctor about this powerful means of prevention if you were not vaccinated as a teenager.

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Join us in creating a more equitable, accessible, and empowered women’s healthcare system. Sign up for our waitlist to be notified when we're available in your state.

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It can be scary to find out you have an abnormal Pap smear or co-test. First of all, take a deep breath. There are many reasons for an abnormal co-test or Pap smear (also called a Pap test); and arming yourself with trusted information and resources to help determine your next steps is your best course of action.

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Before we dive in, it’s important to know that there are three types of tests that screen for cervical cancer: a primary HPV test, a Pap smear, or a co-test (which combines the Pap and HPV). The HPV test is the most sensitive (which means that it is best at picking up disease or infection when it is present) and is the American Cancer Society’s recommended way of screening. However, providers may still conduct Pap smears, most often as a part of a co-test.

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The Pap is a cervical ‘cytology’ screening, which means that it studies your cells. In this article, we’ll discuss different Pap smear (or cytology) results, what they mean, and what to expect as you navigate next steps with your doctor’s guidance.

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What is an abnormal Pap smear? 

A Pap smear is used to detect cell changes in the cervix. It involves collecting cells from the cervix using a smallbrush. (If you’re cringing, we hear you. That’s why we’re working on an improved, at-home experience!)

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The sample is sent to a lab for testing.Your result will come back as either normal or abnormal. An abnormal result means that there are cervical cell changes that are not normal. This usually does not mean that you have cervical cancer, but that the cell changes may require further investigation. The cause of the abnormal cytology results as well as the different abnormal results are often linked to high-risk HPV, which your doctor can test for as part of routine screening.

Here are some of the abnormal cytology results that can be found:

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I had an abnormal Pap smear or co-test—now what?

Depending on the abnormal cytology result, your doctor may recommend a colposcopy. This procedure may look and feel similar to a Pap smear or co-test, although this time, your doctor will use a magnifying device (colposcope) to look at abnormal cells within your cervix. Your doctor may apply a solution to the area of concern, which turns abnormal areas white. Once your doctor identifies the abnormal cells, they may take a small amount of tissue (a biopsy) for testing. These cells will then be sent to a lab for analysis. 

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This is an out-patient procedure. You may, however, experience some mild discomfort after the procedure, mild spotting/bleeding or discharge. These symptoms usually resolve within a few days.

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From here, you’ll wait to hear from your doctor. Waiting on medical results is never fun, so ask your doctor when you can expect to hear your results and how they will communicate the results to you (e.g. email, a phone call, a follow-up appointment, etc.). Based on the results, your doctor will be able to guide you further on next steps, which may include further testing and treatment. 

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