Regular pap tests can detect abnormal cell growth in the cervix. A pap test, also called a pap smear, is simple medical test which should be done every year after a woman becomes sexually active. If there is a problem found, a doctor can prescribe treatments to stop it from developing into cancer. In developed countries, abnormal cell growth is usually detected and treated in this way. Women in developing countries often do not have access to health services where pap smears could be performed. If medical services do exist, women in developing countries often cannot afford the cost. Women in poor or developing countries sometimes do not even know that they should be tested. Transportation to a health office may be a problem. Cultural beliefs may make it embarrassing for a woman to ask a doctor for information or testing, especially if the doctor is a man. Cost and access to healthcare is sometimes also a problem for low income and minority (especially Hispanic and African American) women in the United States since the costs of tests may not be covered by health insurance, if they even have health insurance. The American Cancer Society recommends that women receive both a pap smear and HPV test, regardless of HPV vaccination status. There are specific recommendations depending on how old the woman is and other factors. 