CERVICAL CANCER SCREENING

A few months ago, I read an article in the Washington Post about a young woman with cervical cancer who lost her uterus and ability to have children because of a disease that is very preventable and treatable, as there is a procedure she may have had that would not prevent child bearing if treated early.

I discussed this article with my partners Alane (Dr. Park) and Allison (Dr. Hill) and we all agreed that we have seen very few cases of cervical cancer in our more than 13 years of practice together but the one thing we did find is that most of the the women who got cancer were the ones who had not had pap smears in the last 3 to 5 years.

This rings true for the patient in the article as well as the national statistics.  Even stranger yet, I got the results back just a day or two after reading the article that one of my patients had cervical cancer.  She was a new patient to me, she had HPV (Human Papilloma Virus) in her 20’s and had not come in for a pap in several years.  Her pap came back irregular and I had her come in for a colposcopy and cervical biopsy and to my surprise the area that I biopsied returned positive of cervical cancer.  When I called her with the results she then confessed it had been at least three years since her last pap.

The article stressed the point that women are not getting screening tests because they are poor and do not have access or the money for the testing.  The reality is that there are free clinics in almost every state where women can get free pap smears.  Even sadder is that there are women who have health insurance and the access and they are not getting their pap smears because it is not convenient, or they do not like getting the test or they think they are too busy to get a test or that they will not get cancer.

I think the point is that we need to communicate to every woman who has ever been sexually active that a virus called Human Papilloma Virus or HPV is sexually transmitted and responsible for causing almost all cases of cervical cancer.  It doesn’t matter if you have only had sex with one person – you may have acquired the virus, as there are very few symptoms in men and they may not even know they are a carrier of the virus.

With a pap smear and HPV testing we can identify those women at risk for developing cancer, but pap smear testing needs to be done at the minimum frequency of every three years or more frequently if you have had exposure to HPV.

Cervical cancer is the least frequent of all the gynecologic cancers and this is because of the implementation of pap smears.  The incidence of cervical cancer has decreased almost 50 percent since 1973 because of pap smear screening.  This is the one cancer that we actually have a chance of preventing so get the word out to your friends and family — even though a visit to the gynecologist isn’t always pleasant it can save your fertility and possibly your life.  It only takes a few minutes to do the test and even if you don’t have insurance there are free clinics and programs available for testing.