• What is the cervix?
• What is HPV (Human Papillomavirus)?
• What puts a woman at risk for HPV infection?
• What we know about HPV and cervical cancer (cancer of the cervix)
• What is a Pap test?
• What are the Ontario Cervical Screening (Pap test) Guidelines?
• When is the best time to have a Pap test?
• How to protect yourself against cervical cancer
• Related links

• The cervix is part of a woman's reproductive organs. The cervix is at the top of the vagina and is the opening to the uterus (womb)

• Human Papillomavirus (HPV) is a common infection in both men and women. There are over 100 different types of HPV
• HPV is passed between two people, mostly through sexual activity, but also by skin-to-skin contact
• Low risk types of HPV can cause warts on the skin and genital areas
• High risk types of HPV can cause cervical cancer (cancer of the cervix)

• Sexual activity now or in the past - even a woman who has been sexually active once is at risk
• Sexual activity before age 18
• Having many sexual partners (you or your partner)

• Being infected with a high risk type of Human Papillomavirus (HPV) is a cause of cervical cancer; but other factors also need to be present that increase the chance that the virus will persist
• Most women with HPV infection will not develop cervical cancer. Most people with a healthy immune system will clear the HPV infection on their own
• Factors that increase the chance that the HPV infection will persist include:
• Having a weakened immune system
• Smoking and exposure to second-hand smoke
• Having other sexually transmitted infections
• Using the birth control pill for more than five years
• Having more than five full-term pregnancies
• If the HPV infection persists, some high risk types of HPV may cause changes in the cells of the cervix
• Early changes in the cervix can happen without pain or other symptoms
• If not found and treated, abnormal cells in the cervix can develop into cancer
• It can take many years for cervical cancer to develop
• Regular Pap tests can find changes early and prevent cancer of the cervix

• The Pap test is a simple test used to look at the cells of the cervix (opening to the uterus)
• A Pap test can be done by a doctor or nurse
• By having a Pap test, changes in the cervix can be found early and treated before cancer ever develops
• In most cases, abnormal Pap test results do not mean cancer
• If there are changes, it is important to follow up. Your doctor may do the Pap test again or send you to a specialist for treatment
• A Pap test does not check you for other sexually transmitted infections. Talk to your doctor or nurse about other tests you may need

• Women who are or have ever been sexually active are recommended to start having Pap tests at age 21
• Sexual activity includes sexual intercourse and digital or oral sexual activity involving the genital area with a male or female partner
• Women who are not sexually active by age 21 should delay Pap testing until they are sexually active
• If test results are normal, Pap tests should be repeated every three years
• If test results find abnormal cells, Pap tests will likely be done more often (e.g. every year)
• Women with a weakened immune system and those who have had a hysterectomy should speak with their doctor to determine their cervical screening needs
• Continue having regular Pap tests until at least age 70

• Have a Pap test when you do not have your period
• Do not have sex for 24 hours before the test
• Do not use vaginal medications or douches for 48 hours before the test

• If you have ever been sexually active, have regular Pap tests
• Delay first sexual intercourse until after age 18
• Limit your number of sexual partners
• Use condoms to lower your risk
• Avoid tobacco smoke
• Take care of yourself - eat well, be active every day and get enough sleep
• Talk to your doctor or nurse about the HPV vaccine

• Toronto Public Health: Sexual Health
  • Pelvic exam/Internal Exam
• Toronto Public Health: HPV Vaccine
  • Human Papilloma Virus (HPV)
  • Human Papilloma Virus (HPV) Vaccination Program for Grade 8 Females
• Cervical Screening - Cancer Care Ontario
• Screening for Cervical Cancer-Canadian Cancer Society
• Ontario's Grade 8 HPV Vaccination Program
• HPV Information-The Society of Obstetricians and Gynaecologists of Canada
• Ontario Ministry of Health and Long-Term Care: Cervical Cancer Screening

Last updated July 2012