Attn: People With Cervixes!

Attn: People With Cervixes!

When was your last Pap smear?

Because I am tired of seeing young people (think 40 year olds!) die horribly of an almost completely preventable disease, and I haven't seen the obligatory Tumblr PSA about it, so I'm making my own.

1. CERVICAL CANCER IS REALLY BAD

Cancers that have a good prognosis are usually cancers that can be caught early--like skin cancer, which is easily seen, and therefore usually treated very early. Cervical cancer does not give you symptoms until you have very advanced disease, which means unless someone is regularly testing your cervix, you will likely not be diagnosed early. More than half of people diagnosed with cervical cancer present with advanced disease. 75% of them will be dead within 5 years. For comparison, when caught in the earliest stage, there is a 90% 5 year survival rate. Treatment for those diagnosed is chemo and radiation, and believe me, those are not fun. If you do happen to be in the lucky 25% of survivors, if your cancer comes back, you have an 85% chance of dying within a year. Also! We think of cancer as something that happens to old people, but the average age of diagnosis for cervical cancer is 50.

2. WHO GETS CERVICAL CANCER?

Cervical cancer used to be the most common cause of cancer-related death in women in America, but at this point it's basically a disease of People Without Pap Smears--developing countries, immigrants, low socioeconomic status, BIPOC, rural communities, LGBTQ, etc.

3. HOW DO PAP SMEARS SAVE YOUR LIFE?

A Pap smear is a screening test for two things: HPV, and your cervical cells. HPV is the most common sexually transmitted disease in the world. Literally half of the people in America have some strain of HPV on their body. Most HPV infections go away on their own (in people with healthy immune systems), but some strains are Very Bad, and some people are just Very Unlucky, and the HPV starts causing your cervical cells to turn cancerous. 91% of all cervical cancers are caused by HPV. So a Pap smear looks to see if your have HPV, and if so, is it one of the bad ones? And also, do you have any cancerous cells hanging about in your cervix? And! It takes 10-30 years for HPV to turn those cells into cancer, which means you have a really really long time to catch it before it becomes cancer and cut those pre-cancer cells out!

4. WHAT ABOUT THAT VACCINE?

The thing my dad said I shouldn't get because it might make me a slut. Yes! There is an HPV vaccine! You should get it! It protects you against the nine most common cancer-causing types of HPV. It's recommended starting at age 11, and you can get it up to age 45 now! (It used to be 26, but as of 2020, it's now extended.)You can get it from most primary care doctors, or from Planned Parenthood, CVS, Walgreens, etc. If you get the vaccine you still need Pap smears.

5. I HEARD YOU CAN ONLY GET THE VACCINE IF YOU'RE A VIRGIN

Fake news. While the vaccine does not treat old infections of HPV, it does prevent new ones, so while the benefits are theoretically decreased in those who have already been sexually active, it does not mean you will not benefit from having it!

6. WHO GETS PAP SMEARS?

Everyone with a cervix starting at age 21, until you lose your cervix or until you're 65. You should get them every 3-5 years (depending on your exact age and what test your doctor does).

7. BUT I GOT THE VACCINE

Nice! You still need Pap smears.

8. I HAD ONE AND IT WAS HORRIBLE/I'M SCARED OF THE EXAM

Talk to your doctor about this in advance! Good gynecologists (and other providers) will work with you to minimize discomfort as much as possible. They can use a small speculum and lots of gel, prescribe anti-anxiety medications to take in advance, and some people will even use numbing creams and/or laughing gas.

9. BUT I DON'T HAVE/CAN'T SEE A GYN

Most primary care physicians can do them! So do a lot of urgent care centers!

10. BUT I'M A LESBIAN

HPV can be transmitted through oral/genital contact, hand/genital, and even hand-to-hand-then-genital, so you still need Pap smears.

11. BUT I'M A VIRGIN/ASEXUAL

You still need Pap smears. HPV can be transmitted not just through penetrative sex, but also through oral/genital, hand/genital, and hand-to-hand-then-genital, and also 9% of cervical cancers are not caused by HPV.

12. BUT I'M A TRANSGENDER MAN

If your cervix was removed, then congrats! You do not need Pap smears. Otherwise, unfortunately, you are still at risk for cervical cancer and need to be screened.

13. BUT I'M A TRANSGENDER WOMAN

Neovaginas do not need Pap smears! Congrats! Consider getting the vaccine, though, to prevent spreading HPV to others.

14. BUT I'M A CIS-GENDERED MAN

Congrats! You do not need Pap smears! You should still consider the vaccine though, not only to prevent the spread of HPV to others, but also because HPV causes 50% of all penile cancers as well.

In summary: please please please go get your pap smear. Go get vaccinated. The spread of HPV can be prevented, and cervical cancer can be caught and treated before it even becomes cancer.

DON'T FEAR THE SMEAR