Q. What type of Pap test should I get?

A. Currently, there are two types. The conventional Pap test is a swab of cells taken from your cervix and fixed on a slide. The newer, liquidbased Pap tests such as ThinPrep and SurePath use a solution that helps preserve the cells scraped from the cervix as well as remove mucus, bacteria, and other cells from the specimen that may interfere with the reading.

Although most recent studies show that the liquid-based Pap tests allow added precision in diagnoses, health care professionals emphasize that any Pap test is better than none.

Also, don't assume that just because you had a pelvic exam, your health care professional did a Pap test. Always ask. And always call to find out the results if you haven't heard from your health care professional's office. Don't assume that "no news is good news."

Q. I had a hysterectomy several years ago. Do I still need a Pap test?

A. You might. First, keep in mind that the Pap test screens both the cervix and the vagina for abnormalities. Most guidelines say that if you had a hysterectomy and there was no evidence of pre-cancer or cancer, then you probably don't need to continue having Pap tests. However, if you had a hysterectomy, but still have a cervix, then yes, you need regular Pap tests. Most women have total hysterectomies in which the uterus and the cervix are removed. And, if your cervix was removed, but your hysterectomy was performed because of pre-cancer or cervical cancer, you'll still need a Pap test.

Q. I haven't had a Pap test regularly because I don't have health insurance. Where can I go for help?

A. The National Breast and Cervical Cancer Early Detection Program provides breast and cervical cancer screening services to underserved women throughout the country, including 13 American Indian/Alaska Native organizations. Services are either free or provided on a sliding scale based on your income. For information about access in your area, call 1-888-842-
6355 (select option 7) or log onto http://www.cdc.gov/cancer.

Additionally, Medicare provides 100 percent coverage for a Pap test and 80 percent coverage of the pelvic examination once every 24 months. If you are at high risk for cervical or vaginal cancer, or if you are of childbearing age and have had an abnormal Pap test in the preceding 36 months, it covers these tests every 12 months.¹⁴
-Carolyn Y. Muller, MD
Associate Professor, Gynecologic Oncology
University of Texas Southwestern Medical Center
Dallas, TX

Q. Why should I see a gynecologic oncologist if I have gyn cancer?

A. The scientific literature generally finds that the more experience a physician has in cancer care, the better the outcome. Most obstetrician/ gynecologists, however, only see one or two patients a year with a gynecologic cancer.

Studies find that when gynecologic oncologists are involved in a patient's care compared with ob/gyns providing exclusive care, patients gain improved and more accurate diagnosis, as well as increased rates of correct identification of disease progression, more cost-effective therapy and improved survival.

Gynecologic oncologists finish their training in ob/gyn and then train for another two- to four-years in all aspects of gynecologic cancers, including epidemiology, diagnosis, screening and how to combine surgical, chemotherapeutic and radiation therapies to improve survival.
-James W. Orr, Jr., MD
President, Society of Gynecologic Oncologists
Fort Myers, FL