| No. A Pap smear is not needed
before beginning any method, nor should use of any family planning method be discontinued
if a client develops cervical cancer. |
Although cervical cancer
screening with appropriate follow-up is a good preventive health measure where
economically feasible, this is not a requirement for family planning use. Furthermore,
some people use the Pap smear as a proxy screening test for clinically-inapparent cervical
infection. Because of its low sensitivity and specificity for detecting infection, and
high cost, sexually transmitted disease risk should be assessed by history and clinical
exam of the cervix instead of by Pap smear. Access to family planning should not be
restricted as a means to promote screening. Clients
with cervical pre-cancer can continue using their contraceptive method. Patients with true
cervical cancer will not require contraception if treated by radical surgery or radiation
therapy. While there is a theoretical concern that combined oral contraceptive (COC) use
may affect the progression of the existing disease, women with cervical cancer may
continue to use COCs or any other contraceptive method while awaiting treatment. Due to
risk of infection or perforation, an intrauterine device (IUD) should not be inserted in a
woman who has already been diagnosed with cervical cancer.
- World Health Organization. Improving
access to quality care in family planning: eligibility criteria for contraceptive use.
Geneva: WHO, 1996.
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