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WHO SHOULD HAVE SMEAR TESTS?
All women who have ever had heterosexual intercourse should have regular pap tests. This seems to be the major risk factor for the development of cervical cancer. It has been found that the cancer rate in virgins and exclusively homosexual lesbians is very small, so these groups are not included in routine screening. (But it seems that if an exclusively homosexual lesbian has a sexual partner who has ever had heterosexual intercourse, there may be some risk; no one is excluded from screening if they wish to have it.) Other risk factors which have been suggested include:
• first sexual intercourse at an early age (under 16)
• multiple sexual partners
• sexually transmitted diseases which affect the cervix, including wart virus
(human papilloma virus)
However, more frequent smears in people with increased risk factors are not
recommended, as this has not been shown to be of benefit.
Special cases
Hysterectomy. If a woman has had her entire uterus, including cervix, removed, and she has had no history of cancerous or pre-cancerous change in her reproductive system, she does not need screening. If she has never had a pap smear it is recommended she have a vaginal smear taken, at least once. If her cervix is still present, as is sometimes the case, she still needs screening. If she has had a cancer in the genital tract she will need regular smears taken from her vagina.
Hormone replacement therapy. This treatment does not increase the incidence of cervical cancer, so routine two-yearly screening is recommended.
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