NEW YORK, March 2: The rate of timely cervical screenings has been on the decline in both the United States and internationally — and that’s a red flag. Cervical cancer often doesn’t show symptoms until it has spread, significantly increasing the risk of death.

To understand this troubling trend, AXA Health Insurance surveyed women in the UK and identified the most common misconceptions about cervical screenings.

Pap smears don’t test for cancer: Over half of the women surveyed mistakenly believed that Pap smears test directly for cancer. In fact, the primary purpose of a Pap smear is to detect abnormal cell changes in the cervix — changes that, if caught early, can be treated before cancer develops. These abnormal cells are often caused by the human papillomavirus (HPV), a sexually transmitted infection that usually clears up on its own but can lead to cancerous growth if it persists.

Cervical cancer screenings are not for every 4 years: Nearly 1 in 4 participants believed that cervical cancer screenings are required every four years. However, women between the ages of 25 and 49 should actually be getting screened every three years, the period when cervical cancer is most likely to develop. According to Dr. Pallavi Bradshaw, deputy chief medical officer at AXA Health, "Testing every three years allows your healthcare professional to detect and monitor any changes to the cells in your cervix." For women aged 50 to 64, screenings should occur every five years.

If you test positive for HPV, expect more frequent screenings, often annually, to monitor any changes in your cells.

You can’t get screened before 25: Around 1 in 3 women mistakenly believe they can request a cervical screening before the age of 25. This is generally not the case, as cervical cancer is rare in women under 25. Changes in cervical cells are also common in this age group and typically resolve on their own. Early screenings in this case could lead to unnecessary follow-up tests or treatments, which may cause side effects. However, early screening may be recommended for some women, including those with weakened immune systems, high-risk sexual behaviors, or abnormal symptoms like pelvic pain.

Pap smears don’t take long: AXA’s survey found that about 15% of women thought Pap smears take 30 minutes. In reality, cervical screenings are quick and typically take only a few minutes to complete. “Cervical screenings are quick procedures,” Dr. Bradshaw said.

Pap smears aren’t as painful as you think: The most common reason women avoid Pap smears is fear of pain or discomfort. However, the procedure is usually not as painful as many believe. “Cervical screenings should be painless procedures, with only slight discomfort felt when the speculum is inserted,” Dr. Bradshaw explained. Most women only experience discomfort when the speculum stretches the vaginal walls. If any pain is felt, Dr. Bradshaw recommends informing the doctor immediately.

You still need a screening if you’re not sexually active: While 35% of women correctly identified HPV as a sexually transmitted infection, 7% mistakenly believed that if they weren’t sexually active, they didn’t need to get screened. Dr. Bradshaw clarified that HPV can be spread through non-penetrative sex, skin-to-skin contact with genitals, objects or surfaces with the virus, or even from mother to child. Therefore, it’s essential that all women regularly attend cervical screenings.

Once a leading cause of cancer death in American women, cervical cancer rates have dropped by more than 50% since the mid-1970s, largely due to the HPV vaccine and regular screenings, according to the American Cancer Society (ACS).

While cervical cancer is highly treatable if detected early, it often shows no symptoms until it has already progressed. This makes regular screenings crucial, yet recent studies show a decline in the number of women staying up to date on their screenings. A 2022 study found that the percentage of women overdue for cervical screenings rose from 14% to 19% between 2005 and 2019. This increase was primarily due to lack of awareness about the importance of screenings or simply not knowing when to schedule them.

The ACS estimates that in 2025, about 13,360 new cases of invasive cervical cancer will be diagnosed in the U.S., and 4,320 women will die from the disease.