Routine Screening for Gynecologic Cancer

Compared to breast and colorectal cancer, gynecologic cancer is relatively uncommon, affecting approximately 108,000 women in the United States each year. That said, all women are at risk, and the risk increases with age. Early detection is critical because cancer treatment is most effective when the tumor is found at an early stage.

Gynecologic cancer tends to be “silent.” In other words, a tumor in the female reproductive system—which consists of the uterus, cervix, ovaries, fallopian tubes, vagina and vulva—may not produce noticeable symptoms until it reaches an advanced stage, making early detection a challenge.

Through recent advances in routine screening for gynecologic cancer, however, scientists and clinicians have found that early detection is often possible and, in some cases, gynecologic cancer can even be prevented. As such, routine screening for gynecologic cancer is an important component of women’s healthcare, significantly contributing to improved outcomes and quality of life.

Types of Screening Tests for Gynecologic Cancer

Routine screening involves various examinations and tests designed to detect certain types of gynecologic cancer at an early stage, allowing for prompt intervention and increasing the likelihood of successful treatment. Common screening techniques include:

Pelvic Examination

Often performed as part of a woman’s routine physical or wellness checkup, a pelvic exam can help a physician detect early visible and palpable signs of certain types of gynecologic cancer, including cervical, uterine (endometrial), and ovarian cancer, as well as precancerous changes and other abnormalities that warrant follow-up.

A pelvic exam typically includes:

  • An external visual exam – The physician will look at the vulva to check for sores, irritation, swelling, changes in skin color and other abnormalities.
  • An internal visual exam – The physician will gently insert a special plastic or metal-hinged tool (speculum) into the vagina. Using the speculum, the physician will spread the vaginal walls to gain a clear view of the vagina and cervix.
  • A Pap smear – A pelvic exam for gynecologic cancer might include a Pap test to check for precancerous and cancerous changes in the cervix. It can take several years for abnormal cells in the cervix to progress into cervical cancer, increasing the likelihood of early detection.
  • A manual vaginal exam – The physician will feel the abdomen and pelvis to manually check the size and shape of the uterus and ovaries, which cannot be seen from outside the body. To do so, the physician will insert one or two lubricated, gloved fingers into the vagina and, at the same time, use the other hand to press gently on the stomach area.
  • A manual rectal exam – The physician will insert a lubricated, gloved finger into the rectum to check for tenderness, growths and other abnormalities.

Pap Smear

A Pap smear, or Pap test, is a routine screening procedure for gynecologic cancer, specifically cervical cancer. During this in-office test, a physician will use a small brush to gently collect a sample of cells from the surface of the cervix, which is located at the lower end of the uterus at the top of the vagina. The sample will be sent to a lab for microscopic examination by a pathologist, who can detect precancerous and cancerous changes.

The primary purpose of a Pap smear is to identify abnormal cells that could become cancerous (cervical dysplasia) and early-stage cancer cells. Most cervical cancers can be prevented or found and treated early. A Pap test can also detect vaginal and cervical infections and inflammation, but it does not screen for other types of gynecologic cancer, such as uterine or ovarian cancer.

Human Papillomavirus (HPV) Test

HPV is a common sexually transmitted infection (STI) that can affect the genital area, throat and skin. Almost all sexually active individuals will be infected with HPV at some point in their life, often without symptoms. In most cases, the body’s immune system will successfully attack and destroy the virus. However, a persistent HPV infection may cause cellular abnormalities to develop, which can potentially progress and become cancerous.

HPV is linked to more than 90% of cervical cancer cases. The infection can take up to 10 years to progress into precancerous cells, presenting an excellent window of opportunity for early detection.

Often performed along with a Pap smear, an HPV test is an important component of gynecologic cancer screening because it can detect certain high-risk strains of HPV—such as types 16 and 18—that are known to cause cervical cancer. An HPV test can be performed on the same sample of cervical cells used for a Pap test. Alternatively, a physician may collect a second sample of cells from the cervical canal.

Although the HPV test is effective in detecting the virus that can lead to cervical cancer, it does not detect other types of gynecologic cancer, such as uterine or ovarian cancer.

Why Choose Tampa General Hospital for Gynecologic Cancer Screening

The multidisciplinary team in Tampa General Hospital’s renowned Cancer Institute offers comprehensive, state-of-the-art screening, diagnostic and treatment services for all types of gynecologic cancer, including cervical, uterine and ovarian cancer. Our dedicated specialists in gynecologic oncology use the latest evidence-based practices, emphasizing personalized care and compassionate support. We are proud to be recognized by U.S. News & World Report as One of the Nation's Best Hospitals for Cancer Care for 2024-25.

If you would like to learn more about gynecologic cancer screening, contact TGH at (813) 844-7585 to request an appointment with a gynecologic oncologist at our Cancer Institute in Tampa, FL.

Frequently Asked Questions (FAQs) About Gynecologic Cancer Screening

The following FAQs and corresponding answers provide additional information about gynecologic cancer screening:

What Are the Most Common Screening Tests for Gynecologic Cancer?

The most common screening tests for gynecologic cancer are the pelvic exam, Pap smear and HPV test. Based on the results, a physician may order follow-up diagnostic testing, such as a transvaginal ultrasound or a cancer antigen 125 (CA-125) blood test, to obtain further information.

How Often Should I Get Screened for Gynecologic Cancer?

The optimal frequency of gynecologic cancer screening can vary depending on several factors, including the woman’s age, health history and risk profile. In general, most physicians suggest that women begin having routine Pap smears at age 21 and continue every three years if the results are normal. HPV testing can be done every five years starting at age 30. It is important to consult with a physician for personalized screening recommendations.

Do I Need To Prepare for a Gynecologic Cancer Screening Test?

Preparation can vary based on the type of screening test. For at least 48 hours before a Pap smear or HPV test, it is best to avoid:

  • Having sexual intercourse
  • Using tampons
  • Douching
  • Using vaginal medications and lubricants
  • Using spermicidal foams and creams
  • Applying powders and sprays near the vagina

Although a Pap smear can be performed while a woman is menstruating, most physicians recommend scheduling the test at least five days after the end of a menstrual period. This can help ensure an accurate result. Additionally, it is important to follow the specific instructions provided by the physician.

Can Gynecologic Cancer Screening Detect All Types of Gynecologic Cancer?

No single screening test can detect all types of gynecologic cancer. While valuable and effective, the Pap smear and HPV test are primarily used for detecting cervical cancer. If another type of gynecologic cancer is suspected based on the symptoms or results of a pelvic exam, a physician will typically order follow-up diagnostic testing, such as a transvaginal ultrasound or a cancer antigen 125 (CA-125) blood test. To help ensure early detection and prompt treatment, it is essential for all women to have regular medical checkups, learn about the warning signs of gynecologic cancer and promptly discuss any unusual changes with a physician.