MOUNT VERNON — January is National Cervical Cancer Awareness & Screening Month, a time for women to make sure they are up-to-date on the yearly Pap test.
Cervical cancer, states a poster, “is prejudiced ... it only kills women.” But, when detected very early, the survival rate is 95 percent.
The Pap test — a sampling of cervical cells examined under a microscope — is the best detector of the cell changes that could lead to cervical cancer, and is often covered by insurance, Medicaid or Medicare. But the test is considered so important that free or low-cost tests are often available. For information on where to find such tests, call the National Cancer Institute’s Information Service at 800-4-CANCER.
“Over the last 10 years we’ve switched to different methods to evaluate the Pap test,” said Melissa Goist, M.D., a gynecologist at The Ohio State University Medical Center in Columbus. “Preparation is different now, which we feel has made the test more reliable.
“But women must remember that a Pap test is a screening test ... if it’s normal, it doesn’t mean there’s nothing wrong, and if it’s not normal, it doesn’t necessarily mean something’s wrong. That’s the important thing to remember. Pap tests have about a 70 percent accuracy rate.”
Goist said annual Pap tests should begin when women are 21, or three years after they have begun sexual activity.
“Whichever comes first,” she said.
Pap tests are recommended through age 70.
The human papillomavirus is the greatest risk factor for cervical cancer. The 100-plus types of HPV are often spread through sexual contact. In fact, women with multiple sex partners and women who began sexual activity at a young age, as well as women with human immunodeficiency virus, the precursor to AIDS, are at a greater-than-average risk of cervical cancer. The American Cancer Society states that “Most cases of cervical cancer can be prevented if a woman avoids sexual behaviors that lead to infection with HPV, the leading cause of cervical cancer.”
Modifiable risk factors include cigarette smoking, long-term use of oral contraceptives, obesity, chlamydia infection, multiple full-term pregnancies and a diet low in fruits and vegetables.
The vaccine Gardasil is the first developed to prevent the most common HPV infections. The Food and Drug Administration recommends it be administered before women become sexually active, and recommends it for ages 9 through 26.
“I’m in favor of Gardasil,” said Goist, “and heartily recommend it for my patients through age 26. The vaccine is for four of the most common types of HPV, but not all of them.”
Family history is also a factor of cervical cancer, as is race. According to the American Cancer Society, “Women who have a mother or sister who has had cervical cancer have two to three times increased risk,” and “Hispanic women have over twice the risk of developing cervical cancer compared to non-Hispanic white women, and African-American women have 1.5 times the risk of non-Hispanic white women.”
The ACS states that half of the women who develop cervical cancer are ages 35 to 55; 20 percent are diagnosed at age 65 and older. In Ohio, from 2001 through 2005, reports ACS, 66 percent of cervical cancer victims were 30 to 59. During that time period, there were 482 new cases annually in Ohio, with 157 annual deaths.
Although ACS predicted more than 11,000 new cases in 2008, deaths from cervical cancer — once the leading cause of female cancer deaths — are on the decline and have been every year since 1955, thanks to the Pap test and its increased use, public education and pelvic exams.
Women should know that there are usually no symptoms of cervical cancer until it is advanced. Those symptoms include abnormal vaginal bleeding, longer or heavier than usual menstrual bleeding and increased vaginal discharge. However, less serious health conditions can cause the same symptoms. The ACS states a healthy and safe lifestyle, an experienced gynecologist and annual Pap tests remain a woman’s best prevention against the disease.