I wasn’t worried—until my doctor asked if I was sitting down.
Earlier that week, I’d gone in to follow up on an abnormal Pap smear. I’d put screening off for a few years during the pandemic. She took a few small biopsies, but it didn’t feel urgent. In the past, any abnormal results I had soon cleared up. I’d even had a LEEP, a common procedure to remove precancerous cells from the cervix, in my 20s and moved on with my life.
When she called with the biopsy results, I expected, at worst, a small inconvenience. Another procedure. A light chiding for my delay.
Instead, she told me I had cancer.
Cervical cancer is often described as preventable. It’s usually caused by HPV, a sexually transmitted virus nearly 85% of people will contract in their lifetime, but which rarely progresses to cancer with regular screening and vaccination.
After my diagnosis, those facts felt like an indictment. I replayed the skipped appointments. The voice that said, You’ll reschedule next month. I thought: If this kills me, it will be because I didn’t take it seriously enough.
Spoiler: I did not die. Today, I am gratefully two years cancer-free. But once women in my life knew my story, they began sharing their own with me—and I got a window into how common it is to fall behind on Paps, panic over abnormal results, and keep questions about cervical health to yourself.
What I’ve come to understand is that none of us are reckless. We’re just trying to navigate a risk the medical establishment doesn’t explain well, that’s strangely hard to talk about and often feels abstract, until it isn’t.
So I sat down with my gynecologic oncologist, Amy McNally, MD, at Minnesota Oncology, to separate myth from reality and unpack what she wishes every person with a cervix understood.
Myth 1: Cervical cancer is rare.
Before my diagnosis, I could name exactly one person I knew who had been diagnosed with cervical cancer: an aunt in the 1990s. My mom, a nurse for decades, had never cared for a single cervical cancer patient. I genuinely believed it was something that just didn’t happen anymore.
And in the US, it is relatively uncommon—about 14,000 new cases a year, a fraction compared to the more than 300,000 cases of breast cancer. But worldwide, cervical cancer remains the fourth most common cancer in women, with deaths concentrated in countries where screening is harder to access.
“Cervical cancer is rare in the US because the Pap works,” Dr. McNally tells SELF. “Among gynecologic cancers, the cervix is the one place we have a truly effective screening tool—but you have to do it to get those outcomes.”
When you’re in a generation that doesn’t see it or hear about it as much, she says, people forget about it. And when we forget about it, we stop taking seriously the very thing we’ve been successfully preventing.
Myth 2: Abnormal Paps are no big deal.
Nearly every woman I know has gotten an abnormal Pap result that didn’t lead to anything serious. A Pap is a snapshot of cervical cells, and all kinds of minor things can make that snapshot look off. Often the issue clears on its own, or after handling something simple like a yeast infection.
“So many women have had an abnormal Pap and nothing comes of it,” Dr. McNally tells SELF. “So they tell friends, ‘It was fine,’ and assume that’s always the case.” But, she emphasizes: “An abnormal Pap needs appropriate follow-up.”
One big reason is HPV. It’s extremely common, and most strains don’t cause cancer. But a smaller subset called high-risk HPV (hrHPV) can drive cell changes that lead to cervical cancer over time.
That’s why follow-up is often guided by HPV testing. If atypical cells show up and hrHPV is present, your doctor will usually recommend a colposcopy—a close-up exam of the cervix to look for trouble spots. If atypical cells appear but hrHPV is negative, the plan is often repeat testing and closer monitoring.
Either way, the word “abnormal” shouldn’t scare us, but it does mean we need to pay attention.
Myth 3: HPV usually clears.
We hear it often: “HPV usually clears on its own.” But “usually” is doing a lot of work in that sentence.
“Younger people—under 30—are more likely to clear high-risk HPV,” Dr. McNally explained. “As we get older, we’re less likely to clear it. The blanket statement ‘it usually clears’ isn’t accurate. It’s age-dependent and influenced by other risk factors like smoking and immune status.”
What really raises concern, she says, isn’t a single positive test. It’s persistent high-risk HPV that doesn’t clear on its own within a year or two. That’s why, if you’re HPV-positive, even with a normal Pap, you need closer surveillance than the standard three-to-five-year interval.
HPV is extraordinarily common; most sexually active adults will encounter it at some point. But because it’s an STI, it carries stigma. That stigma paired with the assumption that it will resolve on its own creates exactly the kind of delay that turns something preventable into something serious.
Myth 4: If I don’t have symptoms, I’m fine.
No part of me worried I had cancer. I had zero symptoms. I felt the healthiest I ever had. And that, says Dr. McNally, is why preventative screening is so important.
“Cervical precancer, let alone cancer, is usually asymptomatic,” she told me. “If we’re waiting for symptoms to get care, it’s usually cancer by the time they show up.”
Most things that send us to the gynecologist announce themselves: pain, discharge, itchiness. Cervical cancer doesn’t. That’s the whole reason the Pap exists: to find what your body isn’t telling you.
Myth 5: The HPV vaccine is only for teenage girls.
The HPV vaccine is one of the most effective cancer-prevention tools we have. A recent American Cancer Society report found cervical cancer rates among women ages 20–31 fell 27% in the post-vaccination era, with the steepest drops in states where vaccination rates are highest.
I remember friends getting the Gardasil vaccine in high school, but I didn’t. I was already sexually active and was told I’d missed my chance. Years later, I heard another cutoff: under 26. Ironically, I got my first dose at 32, on the same visit that confirmed I already had cancer.
I wasn’t anti-vaccine, and I wasn’t making a statement. The guidance simply shifted over time, and like a lot of women my age, I stopped asking once I’d heard “too late.”
Dr. McNally put it plainly: “Not only do we have great screening that prevents cervical cancer, we have a vaccine that came out years ago—but it requires families to know about it and choose it.”
Here’s what you should know:
- The ideal time to get the vaccine is before exposure to HPV, which typically means before sexual activity begins. Routine vaccination is recommended at ages 11 to 12, and can start as early as age nine.
- If you’re under 26, catch-up vaccination is recommended regardless of sexual history.
- If you’re 27 to 45, vaccinations are less routine, but still FDA-approved and worth discussing with your doctor.
Dr. McNally also notes that uptake largely depends on adults, not the kids the vaccine is meant to protect. So even if your own window has passed, you may still be making this decision for your child.
Just remember, prevention starts with screening.
Screening guidelines have shifted over the years—which tests, how often, at what ages. It’s easy to use that confusion as a reason to wait. Dr. McNally’s answer: Pick the guideline your clinician follows, and stay consistent with it. That’s it.
If getting to a clinic is the barrier, at-home HPV testing is becoming more widely available, and Dr. McNally sees real promise in it for closing that gap. Just know that a positive result still requires in-person follow-up, and it’s not a substitute for routine reproductive care.
I didn’t have a dramatic story of ignoring obvious warning signs. I did what a lot of us do; I told myself it was probably fine, and I’d get to it.
The good news is that cervical cancer is one of the most preventable cancers we have. The screening works. The follow-up works. You just have to show up for it.
Related:
- 6 Subtle Signs of Cervical Cancer That Every Woman Should Know
- Cancer Rates Are Rising in Young Women. Here’s How to Lower Your Risk
- What to Do If Your Doctor Isn’t Taking Your Period Pain Seriously
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Marley Flueger
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