Cervical
Cancer: A Very Preventable Disease
Regular screenings help
keep women safe
Year 2002 estimates from the
American Cancer Society included approximately 13,000
new cases of invasive cervical cancer in the United States, with nearly 4,100
women dying from this disease.
Worldwide, cervical cancer is
the second leading cancer killer of women.
Yet, most of these cases
are preventable and when found and treated early, cervical cancer
often can be cured.
"Cervical cancer is preventable,"
says Dr. Steven R. Goldstein, a professor of obstetrics and gynecology
at New York University Medical Center.
The
Key Is Early Detection
Ninety-eight to 99 percent
of all cervical cancers are caused by the human papillomavirus,
or HPV. The virus, which is sexually transmitted and comes in several
dozen different varieties, currently infects some 20 percent of
American adults. While most cases of HPV resolve on their own, a
small minority progress to cervical cancer, making it the biggest
health threat to this part of the female anatomy.
Symptom-Free
HPV Puts Women At Risk
One of the problems with
genital HPV infections is that often they do not come with visible
signs and symptoms. A National Institute of Allergy and
Infectious Diseases study found that almost half the women
infected with HPV had no clear symptoms. Further, people infected
but who have no symptoms may not know they can transmit HPV to others.
Recently, researchers
reported in The New England Journal of Medicine
that they had developed a vaccine that had achieved a 100 percent
success rate against the version of the virus responsible for 50
percent of all cases of cervical cancer. Despite these encouraging
results, a workable vaccine is still several years away.
Pap
Test: Best Weapon Against Cervical Cancer
For now, the best weapon
against cervical cancer is screening in the form of a Pap test (also
called Pap smear). And it is very effective.
"If you look at mortality
from cervical cancer from the 1940s before we had the Pap smear
until the 1990s, there's a dramatic decrease," says Dr. Carolyn
D. Runowicz, vice chairman of the department of obstetrics and gynecology
at St. Luke's Roosevelt Hospital in New York City.
"The line is just a sharp
drop, so the Pap smear is absolutely, unequivocally a good example
of screening if done correctly," adds Runowicz, who is also one
of the authors of the American Cancer Society's
cervical cancer guidelines.
A Pap test is a way to examine
cells collected from the cervix, or the "mouth" of the womb (located
at the top of the vagina), for the presence of infection, inflammation,
abnormal cells, and/or cancer. A Pap test, along with a pelvic examination,
is an important part of a woman's routine health care because it
may detect abnormalities that can lead to invasive cancer.
The problem is that not
enough women are being screened, and most cases of cervical cancers
occur in unscreened women, Runowicz says.
"If we could get every woman
screened, we could eliminate this disease like polio," she says. "Women
sometimes think after their last baby, they don't need to go to the
gynecologist anymore. And they really couldn't be more wrong - and cervical
cancer screening is one reason among many."
Runowicz advises women
to start having regular Pap tests within three years of becoming
sexually active or at age 21, whichever comes first.
"Invasive cervical cancer
in this country is virtually unheard of before the age of 20, but
the individual woman needs to speak with her healthcare provider
to determine what is an appropriate screening interval for her,"
she says.
Always consult your physician
for more information.
Risk
Factors For Cervical Cancer
The following have been
suggested as risk factors for cervical cancer:
-
infection with the human papillomavirus
(HPV), most often as the result of unprotected sex
-
infection with the human immunodeficiency
virus (HIV) - the precursor to AIDS, or other conditions that
weaken the immune system
-
age - after age 25, the risk
for invasive cervical cancer increases
-
-
-
poor diet - lacking in fruits
and vegetables
-
having sexual intercourse before
the age of 18
-
having many sexual partners,
and having partners who have had sexual intercourse at a young
age and/or those who have had many partners themselves
Online
Resources
(Our Organization is not
responsible for the content of Internet sites.)
American
Cancer Society
American
College of Obstetricians and Gynecologists
National
Cancer Institute (NCI)
National
Institute of Allergy and Infectious Diseases (NIAID), part of the
National Institutes of Health (NIH)
National
Institutes of Health
The
New England Journal of Medicine
US
Preventive Services Task Force
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February 2003
Cervical
Cancer: A Very Preventable Disease
The
Key Is Early Detection
Symptom-Free
HPV Puts Women At Risk
Pap
Test: Best Weapon Against Cervical Cancer
Risk
Factors For Cervical Cancer
New
Guidelines for Cervical Cancer Screening
Abnormal
Pap Test Results
Online
Resources
In Other Women's Health
News:
New
Guidelines for Cervical Cancer Screening
Task force recommendations are
updated
While regular screening
for cervical cancer is strongly recommended for women between the
ages of 21 and 65, some women can safely discontinue regular screening
or be screened less often, says the US Preventive Services
Task Force.
The task force says the
harm of continued routine screening, such as false positive tests
and invasive procedures, outweighs the benefits of regular screening
for women aged 65 and over who have had regular, normal Pap tests,
and who are not otherwise at high risk for cervical cancer.
Pap testing followed by
appropriate treatment can often effectively prevent invasive cervical
cancer by detecting pre-cancerous lesions before they grow and spread,
the task force says.
The following are some
recommendations from the task force, the nation's leading independent
panel of private-sector experts in prevention and primary care:
-
Cervical cancer screening is
strongly recommended for women who have been sexually active
and have a cervix.
-
Screening is not recommended
for women who have had a total hysterectomy for a benign (non-cancerous)
condition.
-
There is insufficient evidence
to recommend for or against new technologies such as liquid-based
cytology instead of conventional Pap tests to screen for cervical
cancer.
-
There also is insufficient evidence
to recommend for or against the use of human papillomavirus
(HPV) testing as a primary screening tool for cervical
cancer.
Always consult your physician
for more information.
Abnormal
Pap Test Results
According to the National
Cancer Institute (NCI), when the Pap test shows an ambiguous
or minor abnormality, the test is usually repeated to ensure accuracy.
If the test shows a significant
abnormality, a colposcopy may be performed (using an instrument
called a colposcope) to examine the vagina and the cervix.
A Schiller test may also
be performed, in which the cervix is coated with an iodine solution.
A biopsy may be performed
in which the physician removes a small amount of cervical tissue
for examination by a pathologist. This is the only sure way to determine
whether the abnormal cells indicate cancer.
Always consult your physician
for more information.
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