FORT RUCKER, Ala. (January 24, 2013) -- Lyster Army Health Clinic celebrates Cervical Cancer Awareness Month this month by encouraging women to stay educated on the new recommendations for cervical screening.

Cervical cancer is the second most common cancer in women worldwide. Therefore, it is imperative that routine Pap test screening be done based on individual risk factors and the most up-to-date evidence-based recommendations, said Deborah Delk, certified women's health nurse practitioner at Lyster.

Women used to be screened for cervical cancer at age 18 or when they became sexually active, whichever occurred first. This early screening led to aggressive treatment that often caused infertility problems or preterm labor for women, she said.

"Recent clinical trials have shown that cervical cancer typically occurs in women 21 years old and older, not in these very young women," Delk said. "Based on this clinical evidence, the decision to postpone cervical cancer screening until age 21 was made."

However, testing for sexually transmitted infections is encouraged once sexual activity begins. Pelvic exams are done if needed for problems.

Recent changes to annual Pap exams include extending the length of time women are seen between tests. In women between the ages of 21 and 30, if they have had two consecutive negative pap tests, they may extend the time between Pap screenings to every three years.

Another recent change is to extend the Pap smear screening interval to every three years in women ages 30 and older who have never had precancerous cells and who have had two consecutive negative pap smears.

"Cervical cancer is most strongly associated with infection with HPV types 16 and 18," Delk said, adding there are 13 high-risk types of HPV and incorporating an HPV test during a Pap smear screening makes the results for cervical cancer more accurate.

At Lyster, an HPV test can be administered at the time of pap collection, and if both are negative, women can go five years before needing another HPV test with their Pap test, she said.

Annual well-woman exams should continue even without Pap smear screening. There are a number of other gynecologic problems that are screened for during this annual appointment. Screening for uterine, ovarian and breast disorders should continue on a regular basis depending on the age of the woman.

Screening for sexually transmitted infections should continue annually from the onset of sexual activity through age 25 regardless of risk factors, according to the Centers for Disease Control.

To schedule an annual well-woman appointment, call 255-7000 or book online at