Maggie McKay (Host): Cervical cancer is highly preventable and highly curable if caught early. Nearly all cervical cancers could be prevented by an HPV vaccination, a routine cervical cancer screening, and an appropriate follow up treatment when needed. To discuss the importance of these screening measures, our guest is Rachel Chesley, Family Nurse Practitioner at Evergreen Health Primary Care Sultan.

This is Check-Up Chat with EvergreenHealth. I'm Maggie McKay. Rachel, thank you so much for being here today and taking the time.

Rachel Chesley: Thank you so much for having me.

Host: Absolutely. Let's start with what is a Pap test.

Rachel Chesley: So, a Pap test is a type of cervical cancer screening. Pap stands for Papanicolau, which was the doctor that kind of invented this type of cervical cancer screening in the early 1920s. And it's just a way that your healthcare provider can get a sample of cells from the cervix and send those to the lab and they're looked at under a microscope and checking for any abnormalities. This also goes along with an HPV test oftentimes these days, but the Pap is just kind of the general term for lay people when they think they're going to go in for their cervical cancer screening.

Host: And who should have a Pap test and how often?

Rachel Chesley: So when you're talking about healthy people that don't have any other medical problems that could be affecting their screening, for general people, they would want to start at age 21. And this is for anybody that has a cervix, and they would get it every 3 years up through their 20s, so up through age 29. And then, usually when somebody turns 30, we start switching to doing a... Cervical cancer screening with Pap test as well as testing for HPV. And if that's all normal, then they can get it every five years up through age 65.

Host: And is there anything you should or shouldn't do before you go to get your Pap test?

Rachel Chesley: I think mostly just take a deep breath and know you're going to get through it okay. As far as anything medically, there's very few things that are going to really prevent you from getting your Pap. If you're already scheduled for your appointment, don't cancel it because you think there's something wrong. But ideally, avoiding putting anything inside the vagina for 24 to 48 hours prior to the test is ideal. But again, like, if you have intercourse beforehand or something, you should still go to your appointment and you and your healthcare provider can decide if you want to go hard and do it.

Host: What is the difference between screening and diagnostic Pap tests?

Rachel Chesley: The screening Pap tests are the ones that we usually think about that we're asking people to do on that routine interval if there's been no abnormal signs or symptoms. A diagnostic Pap test would be something that your healthcare provider would order if you had some kind of symptom that was concerning and they thought you needed to have that sample.

Host: Rachel, if a Pap test is considered abnormal, does this mean I have cancer?

Rachel Chesley: Usually, it's potentially precancerous cells or some other kind of abnormality that we see under the microscope, but typically it is not cancer. That's why we're encouraging people to get this screening done because we can catch pre-cancers and then treat them before they turn into cancer.

Host: And you mentioned it earlier, HPV, what is that and how can it be linked to cervical cancer?

Rachel Chesley: So, HPV is human papillomavirus, and there are many types of HPV, extremely common, and a lot of people have no idea that they have it. But there are certain types of HPV that are higher risk and can increase your risk for developing cervical cancer.

Host: And how does the vaccine help prevent it?

Rachel Chesley: The vaccine basically helps prevent you from getting HPV, so you don't ever end up with the abnormalities because you never developed that.

Host: So, you only have to get it once in your life?

Rachel Chesley: Yeah. So, it's a series, and depending on what age you start the series, it may be two to three vaccines, and then you're done for the rest of your life, yeah.

Host: Oh, wow. And who should get the vaccine and when?

Rachel Chesley: We like to start sooner than later. So, it's recommended ideally to start at 11 to 12 years old. And it's recommended for anybody that hasn't already gotten the series up through age 26. And then if you're older than that, and you've never had the vaccine between ages 27 and 45, you could consider getting it. And then, that's something to talk to your healthcare provider about getting, whether or not it would be appropriate for you.

Host: I remember when the vaccine came out and they recommended kids, like you said, 11, 12 years old to get it. And there's a lot of controversy over that. Why was that? Just because their bodies aren't fully formed or because they think now they can have sex safely? I don't know.

Rachel Chesley: Right. It's such a great question. I mean, I think it really depends on the person and why there was a concern about that. But I think some people did have that fear that somehow they're authorizing their young adolescent children to start having sex. But that really doesn't pan out in the research and it is just known that it's so beneficial to get it sooner, so that the whole series is complete before the onset of any sexual activity.

Host: Okay. Is there anything else in closing that you'd like to add that we didn't cover?

Rachel Chesley: I just think it's really important for people to Make sure that they're talking to their healthcare provider about making sure they're on top of their screenings and getting them at the recommended interval. And if you ever have any questions about your cervical cancer screening, just feel free to ask. It's not embarrassing to any healthcare provider. That's what we're there for. And no questions are too silly. That's what we want to do, is to help you kind of understand your body and make sure you're healthy.

Host: That's great. Thank you so much. This clears up a lot. So it was great to have it explained and it could very well be lifesaving to someone listening.

Rachel Chesley: Thanks so much for having me.

Host: Absolutely. That's Rachel Chesley. If you'd like to find out more, head on over to our website at evergreenhealth.com for more information and to get connected with one of our providers.

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Detecting cervical cancer at an early stage makes successful treatment and your best possible outcome more likely. Reach out to your primary care physician today to schedule your cervical cancer screening. Thank you for listening. I'm Maggie McKay. And that wraps up this episode of Check-Up Chat with EvergreenHealth.