Cervical Cancer Screening

What is cervical cancer screening?

Cervical cancer screening looks for signs of cervical cancer before you feel symptoms from the disease. It does not screen for ovarian, uterine, vaginal, or vulvar cancers. Two screening tests can help prevent cervical cancer or find it early:

The Pap test (or Pap smear) looks for precancers, cell changes on the cervix that might become cervical cancer if not appropriately treated.

The HPV test looks for the virus (human papillomavirus) that can lead to cervical cancer.

Screening allows for earlier treatment, which may slow or even stop the cancer from progressing.

What Cervical Cancer Screening Guidelines does the WTC Health Program follow?

The WTC Health Program follows evidence-based screening guidelines¹ recommended by the United States Preventive Services Task Force (USPSTF). USPSTF is an independent group of national experts in prevention and evidence-based medicine.

According to USPSTF guidelines, If you are between the ages of 21-29, you are eligible for a Pap smear every three years. If you are between the ages of 30-65, you are eligible for either a Pap smear every three years, an HPV screening every 5 years, or a combination of the two tests every 5 years.

What cervical cancer screening tests can I receive through the WTC Health Program?

Each Clinical Center of Excellence (CCE) and the Nationwide Provider Network (NPN) have established a process for conducting cervical cancer screening for their members. You should contact your CCE or the NPN to discuss your eligibility and options available for cervical cancer screening.

What are the potential risks from cervical cancer screening?

Screening with a Pap smear or HPV testing can have some risks. Abnormal test results can lead to more frequent testing and invasive diagnostic procedures, such as colposcopy and cervical biopsy. These diagnostic procedures can cause vaginal bleeding, pain, infection, and failure to diagnose (due to inadequate sampling).

Abnormal screening test results are also associated with mild psychological effects, such as short-term increases in anxiety, distress, and concern about health.

Talk to your doctor if you are concerned or have other questions about any of these screening tests or diagnostic procedures. In most cases, the benefits of cervical cancer screening outweigh the risks involved with screening.

What happens if I receive a negative result?

A normal result means there are no abnormal cells present. However, the Pap smear test is not 100% accurate. You should return for your next screening test as directed by your doctor. Most of the time, cervical cancer develops very slowly, and follow-up Pap smears should find any changes in time for treatment.

What happens if I receive a positive result for cervical cancer?

When a Pap smear shows abnormal changes, further testing or follow-up is needed. The next step depends on the results of the Pap smear, your previous history of Pap smears, and risk factors you may have for cervical cancer. Your doctor will explain what this result may mean for future testing and treatment.

If a Pap smear shows lesions suspicious for cancer or pre-malignant conditions, the WTC Health Program will cover follow-up and related diagnostic testing as recommended by the National Comprehensive Cancer Network (NCCN) through an enrolled approved provider in the WTC Health Program.

If further diagnostic testing shows invasive cervical cancer or other cancer on the List of WTC-related Health Conditions then your condition might qualify as a WTC certifiable cancer and then all medically necessary treatment of that cancer would be covered by the WTC Health Program, through an enrolled approved provider in the WTC Health Program.

If a Pap smear shows benign conditions or conditions not covered by the WTC Health Program that require treatment, your CCE or NPN healthcare provider will refer you to your primary care provider for follow-up as coverage could not be provided under the WTC Health Program, but would in all likelihood be covered by your health insurance.

Can I still be screened through my personal physician who is not a part of the WTC Health Program?

Yes and in many cases that may be preferable for members who have a longstanding relationship with their private physician. However, if you choose to see your private physician you must pay for those services through your own primary insurance or at your own expense. The WTC Health Program can only pay for screening provided through the Program.

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1. The WTC Health Program follows the USPSTF category A and B recommendations for cervical cancer screening. Available at https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/cervical-cancer-screening2