Florida woman lobbies for cervical cancer awareness

Surviving sister goes to Washington to lobby for cervical cancer awareness

Washington, DC

The 26-year-old Fort Pierce, Fla., resident came here recently to be an advocate for cervical cancer, the disease that took her sister's life four years ago.

Seven months after being diagnosed with cervical cancer, Heather Martin died. She was 28 and uninsured.

"I have to do what I can to get Heather's word out there," Martin said. "And that's what she wanted. I don't want another woman to go through what I went through."

Lung, breast and colorectal cancer all outrank cervical cancer in causing deaths among women, according to the Centers for Disease and Control and Prevention. But cervical cancer is the easiest to prevent.

Since the introduction of the Pap smear, cervical cancer cases have decreased by 75 percent, said Jacqueline W. Miller, medical director for CDC′s National Breast and Cervical Cancer Early Detection Program, at a congressional briefing Jan. 27.

Martin dedicated her Web site, http://Ihatetumors.org, to Heather's memory. The site sells T-shirts with profits going to cancer charities in Heather's name.

Donna Martin campaigns for cervical cancer awareness after losing her sister, Heather, to the disease when Heather was 28 years old. SHFWire photo by Nikki Roberti
Cervical cancer survivor Tamika Felder contacted Martin after she read Heather's story in a 2006 issue of JANE magazine and saw Martin on "The Tyra Banks Show."

Felder is the founder and CEO of Tamika & Friends Inc., a nonprofit organization that informs people about the reality of cervical cancer.

"We have that bond because cervical cancer has touched both of our lives," Felder said of Martin. "We're forever bonded to one another, and we're in this fight together to make sure no one dies of cervical cancer."

Felder asked Martin to lobby for cervical cancer awareness as a representative of Florida.

Martin spoke with Rep. Tom Rooney, R- Fla., and Jessica Moore, a member of his staff.

The CDC created the Breast and Cervical Cancer Early Detection Program in 1991. The program provides access to breast and cervical cancer screening to low-income women.

However, because of under-funding, only 9 percent of eligible women ages 18 to 64 nationwide were screened for cervical cancer in 2009, said Mona Shah, senior policy analyst for the American Cancer Society, at the congressional briefing.

Cervical cancer gets less public attention than breast cancer, Martin said, which leads to under-funding and lack of awareness.

For this reason, Tamika & Friends Inc. took the issue to members of Congress. "They are the ones who can bring in the federal dollars that can make sure awareness is made," Felder said.

Martin said Rooney and Moore were willing to spread the word about cervical cancer prevention.

"How loud do you have to shout before people hear?" Martin said. "She may not have insurance, but she's my sister. How would you feel if it was your daughter, your girlfriend, your wife - someone you cared about?"

Now back in Florida, Martin said she hopes to make her Web site a nonprofit and take the next step in making a difference.

Martin's mother died when she was 18, and her father died just as Heather was diagnosed. Martin held all of their hands as they died. While she admitted it was terrible, she is grateful for the time she had with them.

"But you know what? Now they live through me," she said. "I have three people I have to live for. I have to do what I can."

Cervical cancer by the numbers

The American Cancer Society's most recent estimates for cancer of the cervix in the United States are for 2009:

* 11,270 new cases of invasive cervical cancer (cancer that has spread beyond the cervix)
* 4,070 deaths from cervical cancer

Florida Rates in 2005*

Cervical Cancer incidence rates 2005: 8.7-12.8

Cervical Cancer death rates 2005: 2.5-2.8

*Rates are per 100,000 and are age-adjusted to the 2000 U.S. standard population.

Source: the Centers for Disease and Control and Prevention Cervical Cancer Statistics

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Detect cervical cancer at early stage

Pensacola, FL

According to the American Cancer Society, more than 1,400,000 people in the United States were diagnosed with cancer last year.

February is "National Cancer Prevention Month". By keeping yourself healthy, you can help prevent some types of cancer.

One of the types is cervical cancer. Cervical cancer can be detected by your gynocologist. It's important to have regular pap smears to prevent cervical cancer, which is caused by the STD human papillomavirus.

"In the united states, HPV counts for about 20 million new infections per year. In fact, about 80 percent of all women will acquire HPV by time they're 50-years-old," said Dr. Rodney Rocconi, U.S.A. Mitchell Cancer Institute.

Dr. Rocconi said sometimes HPV is asymptomatic, and if it's left untreated, some types can cause cancer. But with regular pap smears, at least once a year, cancer can be prevented.

"It usually develops over a period of years into a pre-invasive disease so there's some subtle changes that happens to the cervix that smolder for years without symptoms. So what's very important for women is to make sure they get their pap smears on time so that you can catch it in those pre-invasive states. When done so and done properly, those are always curable cases so it's very important," he said.

If a woman does develop abnormal cells on her cervix, and the cells are detected early on, they can be destroyed.

"Treatment for pre-invasive disease is quite easy. It involves either laser, freezing the cells, sometimes even removing parts of the cells like a biopsy. And those types of surgeries can preserve fertility which is important in the young patient population. Early cervical cancers also have a fairly good cure rate as well," said Dr. Rocconi.

He said prevention is key. That's why it's so important for early screening. He also says women should spread the word to female friends and family to get screened, because it could save their lives.

Dr. Rocconi also suggests that woman get vaccinated against the cancer causing strains of HPV. The Gardasil vaccination has been approved by the FDA for girls as young as nine-years-old.

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Pap smear test first line of defense against cervical cancer

Maryville, TN

Don't be telling Dr. Kim Collins you don't have time for your Pap test, or that it's uncomfortable, or that you don't like going to the doctor. She's not buying those excuses.

“Just woman up and do it,” Collins said.

Collins, an obstetrician/gynecologist with Women's Care Group in Maryville, said the importance of having a Pap test cannot be overemphasized. This simple test can detect potential problems in their earliest stages, allowing treatment to begin before the condition becomes cervical cancer. Cervical cancer is a slow growing cancer caused by certain strains of the human papillomavirus (HPV), an extremely common sexually transmitted disease among women and men.

Cervical cancer has no warning signs in early stages. This is why Pap tests are so important. In the Papanicolaou (Pap) test, cells are gathered from the cervix and then examined closely under a microscope for abnormalities. Collins said cervical cancer rates in the United States have fallen more than 50 percent in the past 30 years thanks to the widespread use of the Pap test.

New guidelines for Pap screenings were released in December 2009. Rather than an annual Pap test, women ages 21 to 29 may be screened every two years, and women 30 and above every three years as long as they have had three negative Paps in row. Collins emphasized that an annual physical exam is still indicated because it involves much more than the one test.

According to the Tennessee Department of Health, risk factors for cervical cancer include high-risk sexual behavior; a personal and/or family history of cervical cancer; cigarette smoking; and previous HPV infection. African-American women are more prone to develop cervical cancer than Caucasian and Hispanic women are.

As for having Pap tests, Collins won't accept any excuses for avoiding them.

“I tell my patients this about mammograms and Pap tests,” Collins said. “Is this your favorite thing to do? No. But, when they say this is painful or uncomfortable, my response is, ‘Not as uncomfortable as surgery and radiation and chemotherapy.' There are worse things. If you eventually get diagnosed, you're headed for far more discomfort and pain.”

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Free cervical cancer screenings offered in Valdosta, Florida

Tallahassee,FL

South Georgia Medical Center invites all women who have not had a pap smear in at least three years to get one for free tonight at the Pearlman Cancer Center.

The American Cancer Society says more than 11,270 new cases of invasive cervical cancer were detected last year.

Doctors encourage women to keep up with regular screenings.

"Pap smears actually detect pre-cancerous legions, which is a great advantage in the sense of heading off cancer," said Dr. Boland Woodward, an obstetrician-gynecologist with Southern OB/GYN in Valdosta.

Screenings and breast exams are being offered today at the Pearlman Cancer Center until 7 p.m. But the latest is that they're full with pre-scheduled appointments. And walk-ins will no longer be offered tonight.

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Importance of Pap Smear Test cervical cancer screening emphasized by Missouri doctor

Osage Beach, MO

During Cervical Cancer Screening Month and Cervical Health Awareness Month in January, physicians with Lake Regional Health System in Osage Beach, Mo., are encouraging women and parents of young girls to learn more about early detection and prevention.

“It’s important that women know about this disease,” said Gynecologist Becky Simpson, M.D., with Lake Area Women’s Center in Osage Beach. “It can be treated if detected early, and most cases now can be prevented.”

According to the American Cancer Society, nearly 12,000 U.S. women are diagnosed with cervical cancer each year, and about 4,000 die from it. However, more lives are being saved thanks to increased use of the Pap test — the screening procedure used to find changes in the cervix before cancer develops — and a recently approved vaccination.

Almost all cases of cervical cancer are caused by the Human Papillomavirus — the most common sexually transmitted disease. If an HPV infection isn’t treated or doesn’t clear on its own, it eventually can result in cervical cancer.

“The fastest, easiest way to detect HPV is through an annual Pap test,” Dr. Simpson said. “During this test, we take a sample of cells from the cervix, which is the bottom part of the womb. The cells then are examined for abnormalities or infections, which can be early signs of cancer.”

If an HPV infection is detected and the abnormal cells are treated early, most cases of cervical cancer can be prevented. For this reason, doctors recommend annual Pap tests and pelvic exams for women ages 18 and older, or those who have become sexually active.

Doctors also encourage women ages nine to 26 to get vaccinated against HPV. The vaccine, Gardasil, is a series of three vaccines. They help protect against four types of HPV, two of which cause 70 percent of cervical cancer cases.

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Cervical Cancer and HPV: What you should know

Savannah, GA

January is National Cervical Cancer Awareness Month, and the American Cancer Society estimates that 11,270 new cases of cervical cancer will be diagnosed and about 4,070 women will die from it here in the United States.

The number of deaths caused by cervical cancer has declined significantly mostly because of the use of the Pap test (Pap smear). However, the disease still remains a serious threat especially in African American, Hispanic and Asian women as well as in women who are low income and have no insurance. Cervical cancer is easy to prevent and highly curable when detected and treated early.

What is cervical cancer? Cervical cancer is cancer that starts in the cervix, which is the lower part of the uterus or the womb. Usually the cancer grows slowly and many women do not know they have the disease because they do no have any symptoms.

The main cause of the disease is a virus called human papillomavirus (HPV), which is spread through sex and causes changes in the cervix. Almost 99% of all cervical cancers are caused by HPV. Most HPV infections do not have symptoms and most people do not even know they are infected. Majority of the time, HPV infections clear up on its’ own and do not cause cancer. However, if the infection does not go away, it can cause the normal cells in the cervix to become precancerous. Pre-cancer cells do not always turn into cancer and most will return to normal. If they are not found and treated, the precancer cells may turn into cancer.

The only way to fully prevent HPV infection is through abstaining from sexual activity. Another way to prevent infection is through the HPV vaccine, which was approved by the Food and Drug Administration in 2006. The vaccine protects against HPV types 16 and 18, the two types that cause 70% of cervical cancer. The vaccine is recommended for girls and women ages 11 to 26. The American Cancer Society recommends that women talk to their doctor about whether the vaccine is right for them.

All women are at risk for cervical cancer. There are certain risk factors that increase a woman’s chance of getting the disease. In addition to HPV infection, other risk factors include smoking, having HIV or any disease that affects the body’s immune system, Chlamydia infection, and long-term use of birth control. Having multiple sexual partners and having sex at an early age may also increase the chances of getting cervical cancer. Early detection is the key to preventing and treating cervical cancer. Cervical cancer screening using the Pap test is the most effective and reliable form of prevention. Getting regular Pap tests can save your life. The Pap test locates pre-cancer and abnormal cells that may become cancerous if not found early and left untreated. The HPV test can also be used to find change in the cells in the cervix.

Some simple guidelines for cervical cancer screening by the American Cancer Society are as follows: All women should begin getting annual Pap tests about 3 years after they become sexually active but no later than age 21; starting at age 30, women who have had normal Pap tests 3 years in a row should get screened every 2-3 years; women 70 years or older who have had normal Pap tests at least 3 years in a row and no abnormal tests in the last 10 years can stop being screened; however, you should talk to your doctor or other healthcare professional to determine how often you should have a Pap test.

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Cancer Centers of the Carolinas honors Cervical Cancer Month by building awareness

Greenville, SC

January is Cervical Cancer Month, a time set aside to raise awareness of cervical cancer. In the United States, approximately 11,270 women will be diagnosed with cervical cancer in 2010. However, invasive cervical cancer is highly preventable. That’s why Cancer Centers of the Carolinas (CCC) is making it their goal to stress the importance of regular Pap tests in preventing cervical cancer, the role of Human Papillomavirus (HPV) infections in the development of the disease and treatment options if abnormal cells are detected.

The National Cancer Institute (NCI) says that failure to get a Pap test, as well as failure of the test itself, are common for women who have been diagnosed with cervical cancer. In fact, 60 to 80 percent of the women who are newly diagnosed with cervical cancer in the United States report they have not had a Pap test in the past five years. According to the NCI, the key to preventing death from cervical cancer is regular screening to detect abnormalities in the cells of the cervix early, before they become cancerous.

CCC is committed to helping women in the Upstate and their families win the battle against cervical cancer. They do this by providing easy access to a full range of advanced cancer care services
in a community-based setting that allows patients to remain close to home and their support networks of family and friends. CCC strongly believes in this comprehensive community-based approach to the management of their patients’ cancer treatment and follow-up care.

CCC has oncologists who use the latest advances in technology and therapies to deliver complete and compassionate care. As experts in cancer, CCC is a leader in research and participates in many clinical trials that result in new therapies for patients battling cervical cancer.

Serving Upstate communities for more than three decades, Cancer Centers of the Carolinas (CCC) is a community-based, physician-owned practice with 28 board-certified oncologists practicing in multiple locations across the Upstate of South Carolina.

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Pap smear test: Regular cervical cancer screening should not be missed, says Illinois Public Health Director

Decatur, IL

Sexual health is a notoriously difficult subject to bring up, but time after time, research has shown that awareness saves lives.
In recognition of Cervical Cancer Awareness Month, Illinois Public Health Director Dr. Damon T. Arnold's office issued a press release urging Illinois women to proceed as recommended with their regular screenings.
Dr. Derin Rominger, a Decatur Memorial Hospital obstetrician-gynecologist, said the guidelines for cervical cancer screenings have changed in recent years.
The former guidelines stated that women should begin receiving Pap smears, tests for changes in the cells of the cervix, at age 18 or upon becoming sexually active, Rominger said.
"We just don't see that much cervical cancer in the teenage group," he said. "They seem to be able to clear the virus that causes these problems."
New guidelines state that women should start getting the tests at age 21 or three years after becoming sexually active, Rominger said.
Once women start receiving the screenings, those who fall into the lower-risk categories of being in a monogamous relationship and having a series of negative Pap smears will need them less often, Rominger said. But those who have had abnormal smears in the past, have had new sexual partners or are immunosuppressed will need to be screened annually, he said.
Research has shown a strong connection between certain strains of human papillomavirus, or HPV, and cervical cancer, Rominger said. Two main strains are responsible for 90 percent of cervical cancers, he added.
"Basically, we've known for a long time there was some sort of a factor," Rominger said of the relationship between HPV and cervical cancer.
In the past few years, vaccines such as Merck's Gardasil and GlaxoSmithKline's Cervarix, which protect against some of the strains known to cause cervical cancer, have become available.
Vaccination is one thing young women can do to reduce their risk of HPV infection and, ultimately, cervical cancer, Rominger said. Women between the ages of 11 and 26 currently are eligible for vaccination.
Although doctors prefer to give the vaccine to women before their "sexual debut," Rominger said, "just because she's been sexually active or had an abnormal Pap smear doesn't mean she's not eligible for the vaccine."
Another measure of protection is to practice safer sex, he said. Use a condom to protect against transmission of the virus and other sexually transmitted diseases.
Refrain from smoking, which has been shown to double the risk of cervical cancer, Rominger said. And be sure to get in for routine Pap smears as they are recommended by a physician, he added.
"The whole key is that early detection," Rominger said.
In 16 years of practice, he has seen only seven cases of cervical cancer. All of those women had gone at least 10 years or more without a Pap smear, he said.
The screenings save lives by locating precancerous cells, and doctors sometimes must take measures to remove those growths, Rominger said.
"Those are the ones that have a greater chance of progressing to cervical cancer," he said.
According to the recent release from Arnold's office, it is estimated that in 2010, 610 women in Illinois will be diagnosed with cervical cancer, and about 180 will die from it.
But those deaths are avoidable through routine screenings and preventive measures, Arnold said.

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Don't skip cervical cancer screenings

Decatur, IL

Sexual health is a notoriously difficult subject to bring up, but time after time, research has shown that awareness saves lives.

In recognition of Cervical Cancer Awareness Month, Illinois Public Health Director Dr. Damon T. Arnold's office issued a press release urging Illinois women to proceed as recommended with their regular screenings.

Dr. Derin Rominger, a Decatur Memorial Hospital obstetrician-gynecologist, said the guidelines for cervical cancer screenings have changed in recent years.

The former guidelines stated that women should begin receiving Pap smears, tests for changes in the cells of the cervix, at age 18 or upon becoming sexually active, Rominger said.

"We just don't see that much cervical cancer in the teenage group," he said. "They seem to be able to clear the virus that causes these problems."

New guidelines state that women should start getting the tests at age 21 or three years after becoming sexually active, Rominger said.

Once women start receiving the screenings, those who fall into the lower-risk categories of being in a monogamous relationship and having a series of negative Pap smears will need them less often, Rominger said. But those who have had abnormal smears in the past, have had new sexual partners or are immunosuppressed will need to be screened annually, he said.

Research has shown a strong connection between certain strains of human papillomavirus, or HPV, and cervical cancer, Rominger said. Two main strains are responsible for 90 percent of cervical cancers, he added.

"Basically, we've known for a long time there was some sort of a factor," Rominger said of the relationship between HPV and cervical cancer.

In the past few years, vaccines such as Merck's Gardasil and GlaxoSmithKline's Cervarix, which protect against some of the strains known to cause cervical cancer, have become available.

Vaccination is one thing young women can do to reduce their risk of HPV infection and, ultimately, cervical cancer, Rominger said. Women between the ages of 11 and 26 currently are eligible for vaccination.

Although doctors prefer to give the vaccine to women before their "sexual debut," Rominger said, "just because she's been sexually active or had an abnormal Pap smear doesn't mean she's not eligible for the vaccine."

Another measure of protection is to practice safer sex, he said. Use a condom to protect against transmission of the virus and other sexually transmitted diseases.

Refrain from smoking, which has been shown to double the risk of cervical cancer, Rominger said. And be sure to get in for routine Pap smears as they are recommended by a physician, he added.

"The whole key is that early detection," Rominger said.

In 16 years of practice, he has seen only seven cases of cervical cancer. All of those women had gone at least 10 years or more without a Pap smear, he said.

The screenings save lives by locating precancerous cells, and doctors sometimes must take measures to remove those growths, Rominger said.

"Those are the ones that have a greater chance of progressing to cervical cancer," he said.

According to the recent release from Arnold's office, it is estimated that in 2010, 610 women in Illinois will be diagnosed with cervical cancer, and about 180 will die from it.

But those deaths are avoidable through routine screenings and preventive measures, Arnold said.

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HPV infects 56% of young lovers, new study finds

Montreal, Canada

A groundbreaking study of young Canadian couples in new sexual relationships has found that more than half -- 56% -- are infected with the human papilomavirus.

Of that group, 44% had the type of HPV that causes cancer of the cervix and penis.

"Our study is the first to investigate HPV transmission in a large number of new couples among young adults," Dr. François Coutlée, a researcher at the Centre Hospitalier de l'Université de Montréal where the HPV tests were analyzed, said in a news release. "The results suggest that many HPV transmissions occur at the start of new relationships, which reinforces the need for prevention."

The study's coordinator said researchers weren't surprised by their findings.

"It is a high number, but that number was not entirely unexpected," Ann Burchell, a post-doctoral fellow at McGill University's cancer epidemiology unit, told the CanWest News Service. "We know that HPV is a very common infection already, particularly in young people. We know that people are at a high risk of getting HPV just after acquiring a new partner."

HPV infections are common: more than 70% of women and men will be infected at some point. But the vast majority of people experience no symptoms, and the infection lasts between one and two years. Of women infected with HPV, fewer than 1% will develop cervical cancer.

The findings were published in the January issues of Epidemiology and Sexually Transmitted Diseases.

In October, the U.S. Centers for Disease Control and Prevention recommended that all girls ages 11 or 12 be given the HPV vaccine, Gardasil.

Two months earlier, the CDC reported that the vaccine was linked to 32 unconfirmed deaths and showed higher incidences of fainting and blood clots than other vaccines. That concerned some doctors and parents. Others were reassured by the report, noting that its side effects were neither more unusual nor more serious than other vaccines.

The CDC addresses health concerns about the vaccine.

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Less frequent Pap tests now recommended for cervical cancer screening

New York, NY

Initial cervical cancer screening should begin at age 21 and can be rescreened less frequently than previously recommended, according to newly revised, evidence-based guidelines issued recently by The American Congress of Obstetricians and Gynecologists (ACOG).* Most women younger than 30 should undergo cervical screening once every two years instead of annually, and those age 30 and older can be rescreened once every three years. Annual gynecological visits are still recommended and important for a woman's overall health.

Cervical cancer rates have fallen more than 50 percent in the past 30 years in the United States, believed to be due to the widespread use of the Pap test. The incidence of cervical cancer fell from 14.8 per 100,000 women in 1975 to 6.5 per 100,000 women in 2006. The American Cancer Society estimates that there will be 11,270 new cases of cervical cancer and 4,070 deaths from it in the United States in 2009. The majority of deaths from cervical cancer are among women who are screened infrequently or not at all. Cervical cancer is a slow growing malignancy caused by certain strains of the human papillomavirus (HPV). HPV also is responsible for genital and anal warts, as well as oral and anal cancer.

"The tradition of doing a Pap test every year has not been supported by recent scientific evidence," says Dr. Alan G. Waxman of the University of New Mexico. Review of the literature shows that screening at less frequent intervals prevents cervical cancer just as well, with less incurred costs, and avoids unnecessary interventions that could be harmful, especially to reproductive aged women.

ACOG now recommends that women from ages 21 to 30 be screened every two years instead of annually. Women 30 and older who have had three consecutive negative cervical cytology test results (Pap smears) may be screened once every three years. Women with certain risk factors may need more frequent screening, including those who have HIV, are immunocompromised, were exposed to diethylstilbestrol (DES) in utero, and have been treated for cervical intraepithelial neoplasia (CIN) 2, CIN 3 (both pre-malignancies of the cervix), or cervical cancer.

Moving the baseline cervical screening to age 21 is a conservative approach to avoid unnecessary treatment of adolescents, which may have economic, emotional, and future adverse childbearing implications. ACOG previously recommended that cervical screening with Pap smears begin three years after first sexual intercourse or by age 21, whichever occurred first. Although the rate of HPV infection is high among sexually active adolescents, invasive cervical cancer is rare in women under age 21. The immune system clears the HPV infection within one to two years among most adolescent women. Because the adolescent cervix is immature, there is a higher incidence of HPV-related precancerous lesions, called "dysplasia." However, the large majority of cervical dysplasias in adolescents spontaneously resolve without any treatment. This means in this age group there may be a higher number of false-positives that are followed by more invasive tests or more frequent Pap smears.

A significant increase in premature births has recently been documented among women who have been treated with excisional procedures for dysplasia, called cold-knife cone excision or LEEP excision, in which a portion of the cervix is surgically removed either in the office or operating room. Adolescents have their childbearing years ahead of them, and surgically treating the cervix with such excisional procedures has been shown to adversely affect their pregnancies. Therefore, it's important to avoid unnecessary procedures. We argue that early screening for cervical cancer in adolescents only serves to increase their anxiety, and may lead to overuse of procedures for a disease that has shown to resolve usually on its own.

Routine cervical cytology testing should be discontinued in women (regardless of age) who have had a total hysterectomy (removal of the cervix along with the uterus) for noncancerous reasons, as long as they have no history of high-grade dysplasia.

ACOG's recommendations on the upper age limit for discontinuing cervical screening remain the same. It is reasonable to stop cervical cancer screening by age 70 among women who have three or more consecutive negative Pap smear results and no abnormal test results in the past 10 years. ACOG also recommends that women who have been vaccinated against HPV should follow the same screening guidelines as unvaccinated women.

Of importance to impress on our patients is that annual gynecologic examinations are still appropriate and recommended, even if cervical screening with a Pap smear is not performed at each visit. There's more to a visit to the gynecologist than just the Pap smear.

Why should you believe this study? ACOG is the nation's leading group of professionals providing health care for women. Recommendations are evidence based and highly regarded among health care professionals. www.acog.org

*ACOG is formerly known as The American College of Obstetricians and Gynecologists.

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Cervical cancer screening encouraged by health officials

Springfield, IL

Illinois' public health director Dr. Damon Arnold is urging women over the age of 21 to be screened for cervical cancer.

Arnold's message is in recognition of Cervical Cancer Awareness Month. The most recent information for Illinois shows, in 2006, 572 women were diagnosed with cervical cancer. That year, 173 women died of the disease.

The good news is almost every cervical cancer death is preventable through early detection, treatment and follow-up.

A Pap test is the most common screening test for cervical cancer.

Regular exercise, quitting smoking and eating a healthy diet are steps women can take to prevent cancer.

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One out of 142 girls in Missouri will have cervical cancer

Jefferson City, MO

The Missouri Department of Health says Missouri is ranked fourteenth in the world for new cases of cervical cancer. One in 142 girls born today will be diagnosed with cervical cancer sometime in life. It is about 240 people in Missouri.

Cervical cancer is mostly caused by contracting Human Papilloma Virus, or HPV.

Health Department Nurse Susan Kneeskern says children need to be vaccinated before they become sexually active. The three-dose series should be introduced from age nine to 11 or 12, the department recommends.

Kneeskern said, “The vaccine can be administered to females up to age 26, but those who are sexually active could get less benefit from it since they might have already gotten one or more types of HPV type targeted by the vaccine.”

Two HPV vaccines are FDA-approved and these are Gardasil from Merck, produced in yeast, and Cervarix from GlaxoSmithKline, produced in insect cells, till date.

Dr Santos, a gynecologic oncologist, said even after women get vaccinated they will undergo screening with HPV DNA testing or biomarker testing at around 30 years.

HPV is the leading cause of cervical cancer in women.

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January is Cervical Health Awareness Month

Courtesy National Cervical Cancer Coalition

Somewhere around 11,000 new cases of cervical cancer will be diagnosed among American women in 2010. An estimated 4,000 women will die from this disease, the only cancer known to be exclusively caused by a common virus, the Human Papillomavirus (HPV). High-risk HPVs may cause cases of mouth, head and neck cancer as well, according to research recently completed.

Other than those practicing lifelong abstinence, most adults acquire an HPV infection during their lifetimes. But mostly the infections turn out harmless and dissappear on their own.

Other infections persist and if they remain untreated for years, or even decades, may lead to cancer. Precancer detection is essential for treatment to prevent the development of cancer. Get a Pap test regularly from a gynocologist in order to detect when HPV causes cells to change long before they progress to cervical cancer.

Regular screening is still recommended despite any new information coming out. Cervical cytology screening is recommended for women every two years beginning at age 21.

The National Cervical Cancer Coalition (NCCC) founded in 1996, is a grassroots nonprofit organization dedicated to serving women with, or at risk for, cervical cancer and HPV disease. For more information visit the Web site at www.nccc-online.org.

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January 2010 is Cervical Health Awareness Month, cervical cancer education is key

Belleville, IL

Resolutions abound in the New Year, and having recommended health screenings should be a priority. January is Cervical Health Awareness Month and a prime time to highlight the importance of routine Pap tests. Raising awareness among women with disabilities is especially important because, as a group, they are less likely to get the life-saving test, according to Allsup, a nationwide provider of Social Security disability representation and Medicare services.

In the United States, 11,000 new cases of cervical cancer will be diagnosed in 2010 from human papillomavirus (HPV)-caused tumors. HPVs are sexually transmitted via skin-to-skin contact. Recent research indicates the virus also causes some cases of cancers of the mouth, anus, head and neck in men and women, according to the National Cervical Cancer Coalition (NCCC).

Cervical cancer is the easiest female cancer to prevent with regular screening tests and follow-up. The Pap test (or Pap smear) looks for cell changes on the cervix that might become cervical cancer if not treated appropriately. The HPV test looks for the virus that can cause these cell changes.

“It’s important to remember that cervical cancer is a preventable disease—as long as it’s caught early enough,” said NCCC executive director Sarina Araujo.

In fact, when cervical cancer is found early, it is highly treatable and associated with long survival and good quality of life. Unfortunately, six out of 10 cervical cancers occur in women who have never received a Pap test or have not been tested in the past five years.

This problem is especially pronounced among women with disabilities. Research shows that women with disabilities are less likely to get Pap tests than women without disabilities.

“There is a wide range of reasons for this disparity,” said Allsup manager Tai Venuti, MPH. “The disability may make the exam itself more difficult, as in the case of spinal cord injuries or disorders, or special equipment may be needed. Another barrier could be as simple as not having adequate transportation to the doctor.”

In addition, healthcare facilities may be inaccessible and ill-equipped to serve people with disabilities, so preventive services like Pap smears are overlooked.

Women diagnosed with cervical cancer and unable to work may be eligible for Social Security Disability Insurance (SSDI) benefits. The Social Security Administration uses a five-step process to determine if a cancer patient qualifies for SSDI benefits.

1. Determine if an individual is “working (engaging in substantial gainful activity)” according to the SSA definition.

2. Conclude the cancer disability must be severe enough to significantly limit one’s ability to perform basic work activities needed to do most jobs.

3. Ask if the cancer disability meets or equals a medical listing.

4. Explore the ability of an individual to perform work they have done in the past despite their cancer. If the person cannot, then the process proceeds to the fifth and final step.

5. Review age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform.

Public education and outreach are keys to promoting good cervical health for all women, and eliminating screening disparities for women with disabilities. For more information and to learn how you can help during Cervical Health Awareness Month, visit the National Cervical Cancer Coalition (NCCC).

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Having sex at an early age can double risk of cervical cancer

London, UK

A study shows women are at greater risk from the disease by becoming sexually active at a young age, prompting campaigners to call for the screening age limit to be lowered

The study published in the British Journal of Cancer into why poorer women have a higher risk of the disease found they tended to have sex four years earlier than more affluent women.

In England, women do not qualify for NHS screening until they reach 25, perhaps ten years after they may have contracted HPV, the sexually transmitted virus that causes most cases of cervical cancer.

The age at which a woman had her first baby was also an important factor, according to the study of 20,000 women by the International Agency for Research on Cancer.

But smoking and the number of sexual partners did not account for any of the difference.

Dr Silvia Francheschi, who led the study, said the risk of cervical cancer was higher in women who had their first intercourse aged 20, compared with 25.

She said: “In our study, poorer women become sexually active on average four years earlier. So they may also have been infected with HPV earlier, giving the virus more time to produce the long sequence of events that are needed for cancer development.”

Women aged between 25 and 49 are offered checks every three years in England, while women aged 50 to 64 get five yearly checks for pre cancerous changes that could develop into cancer without treatment.

Dr Lesley Walker, of Cancer Research UK, said: “These results back up the need for the HPV vaccination to be given in schools at an age before they start having sex, especially among girls in deprived areas.”

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Early detection is key to prevent cervical cancer

Recent Pap test recommendations and new vaccine approvals have brought cervical cancer screening into the spotlight and may have some women confused about what to do to protect themselves. Experts agree that routine screening is essential in the fight against cervical cancer, which is entirely preventable because it has a known cause-"high-risk" types of the human papillomavirus, or HPV.

According to the American Cancer Society, more than 11,000 women in the U.S. are diagnosed with cervical cancer each year. Eight out of 10 women are estimated to get HPV at some point in their lives, but the virus usually goes away on its own. However, infection with certain high-risk types of HPV may persist in some women and cause abnormal cells to develop into cervical cancer.

"We now have a full range of tools to protect future-and current-generations of women from developing cervical cancer, including vaccines, the Pap test and the HPV test," says Dr. Marie Savard, ABC News Medical Contributor and author of "Ask Dr. Marie: Straight Talk And Reassuring Answers To Your Most Private Questions." "Each tool has its own distinct function, so it's important to know the age recommendations, differences and how the tools can be used together to prevent cervical cancer."

Advances In Cervical Cancer Prevention

Screening technologies such as Pap and HPV testing allow for early detection of cervical cancer, while vaccines for girls and young women ages 9-26 can prevent future infections with certain cancer-causing HPV strains. Recently, the American Congress of Obstetricians and Gynecologists changed its Pap test screening recommendations to begin at age 21 and continue every other year. These new guidelines also say that women 30 and over can have a Pap test every three years when the Pap is "normal."

Doctors use Pap and HPV tests to determine a woman's risk for cervical cancer. A Pap looks for abnormal or precancerous cells caused by HPV, while the HPV test detects high-risk strains of the virus itself. HPV testing, performed together with the Pap in women age 30 and older, identifies women with high-risk HPV infections that can cause cervical cancer, enabling diagnosis and treatment to be put in place before cervical disease develops.

For women age 30 and older, who are at the greatest risk for cervical cancer, both tests can be performed at the same time and are covered by most insurance plans. Women with abnormal Pap results or who test positive for high-risk HPV should be monitored more closely by health care professionals so that any cell changes can be tracked and treated-before they can become cervical cancer.

"I had barely heard of HPV and yet here I was, diagnosed with cervical cancer at age 34," says Lori Stone, a cancer survivor and founder of the Pacific Northwest Cervical Health Coalition. "After years of normal Paps, an HPV test called the digene HPV Test alerted my doctor to do more follow-up, and we were able to catch my cancer at a stage when it was still very treatable."

Early detection of abnormal cervical cells is key so you can be closely monitored and treated accordingly. Take an active role in cervical cancer prevention! Be your own best advocate-ask your doctor what prevention tools are right for you: Pap testing, HPV testing and HPV vaccination.
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New cervical cancer screenin guidelines "surrounded by confusion"

Wilmington, NC

Video

Doctor Sandra Hall has been busy fielding calls from patients concerned about new pap smear and mammogram recommendations. Last week, a government task force said women should not start getting mammograms at age forty - instead, they should wait until they turn fifty.

“They said from age 40 to 49 that benefit was small, they would have to screen 1,900 women to save one woman's life compared to age 50 to 59 where you'd have to screen about 1,300 women. They're not saying there isn't a benefit; they're saying it's small,” explained Dr. Sandra Hall.

While that was sinking in, women under thirty were then told annual pap smears were no longer needed. They were told that an exam every two years would be enough to catch slow-growing cervical cancer.

Dr. Hall said, “It can take ten, sometimes 20 years to grow. We know a lot more about cervical cancer these days, about the HPV virus that causes cervical cancer, and it isn't women being screened dying from cervical cancer, it's women who aren't being screened.”

Still, Doctor Hall said it is important to remember this task force is made up of people who aren't oncologists, treating cancer on a regular basis. These recommendations do not apply to everyone, especially if you have ever had an abnormal pap smear or a history of cancer in your family.

“I think the most important thing is to talk to your doctor. Your individual risk is so important and these are general recommendations, they're not mandates,” added Dr. Hall.

So even though it is now recommended that women under thirty, who have never had an abnormal pap smear, wait two years between tests, Doctor Hall said you still need a pelvic exam every year.

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Will cutting back on teen Pap tests result in more STDs?

Atlanta, GA

Teen girls can skip Pap tests, according to new guidelines that say women should start cervical cancer screening at age 21. But some experts are concerned that rates of sexually transmitted diseases or unplanned pregnancies could increase without the Pap test to prompt a doctor's visit.

As it stands, as many as one in four U.S. teenage girls has had an STD at some point in her life, often soon after she becomes sexually active, according to research published this week in Pediatrics.

"I am concerned that without the recommendation for young women to get Pap smears early on, they will lose important opportunities to seek advice and to learn about their health -- particularly their sexual health -- at a time in their lives when they need it most," says Kimberly Spector, an adolescent-health educator in Los Angeles, California. "Regardless of the tests performed during a gynecologist visit, the conversation regarding sexual health risks and preventative measures can be very informative and empowering for young patients."

In the past, women were told to start Pap tests, which can detect abnormal cells in the cervix, three years after becoming sexually active or at age 21 -- whichever came first. However, these abnormal cells often go away on their own, particularly in young women. If they don't, such cells grow so slowly that catching them at age 21 is still early enough to remove them before they become cancerous. And catching them sooner could lead to unnecessary tests and treatments that sometimes damage the cervix, increasing the risk for a premature birth later in life.

The new guidelines still recommend that girls who are under 21 see a gynecologist; they just don't need Pap tests, according to the American College of Obstetricians and Gynecologists. The fear, however, is that some teens may misinterpret the new rules and miss out on important discussions about contraception and protection against STDs such as gonorrhea, bacterial vaginosis, chlamydia, and human papillomavirus.

"If women hear that they no longer need Pap tests annually or until they are 21, perhaps they wouldn't seek any preventive health care, and whether this results in decreased screening and identification of chlamydia and other STDs remains to be determined, but it is concerning," says Harold Wiesenfeld, M.D., the director of the division of reproductive infectious diseases at the University of Pittsburgh School of Medicine, in Pennsylvania.

Health.com: The most common STDs: HPV, herpes, and chlamydia

Many STDs, including chlamydia and gonorrhea, have no symptoms. "Unless screened, young women will remain undiagnosed, untreated, and at risk for complications, including pelvic inflammatory disease, which results in infertility," says Wiesenfeld, who is also an associate investigator at Magee-Womens Research Institute, in Pittsburgh. "[Still] the Pap test is not the 100 percent trigger to do chlamydia screening," he says. "We need to do a better job about STD screening overall."

Teens who are sexually active should use contraception and take steps (such as using condoms) to prevent STDs, even if they don't need Pap tests, says Alina Salganicoff, Ph.D., the vice president and director of women's health policy for the Henry J. Kaiser Family Foundation, an advocacy group based in Menlo Park, California.

Health.com: Who's most at risk for STDs?

"We are going to have to pay special attention to how we educate our adolescent patients about contraception and STD prevention," she says.

However, most experts agree that Pap tests are indeed unnecessary for younger women and that the new guidelines will not put them at risk. Most also agree that the new guidelines are not an effort to limit care.

"I do not fear the consequences because these guidelines are well thought out and give us a great opportunity to focus on who is at risk for cervical cancer," says Bobbie Gostout, M.D., the chair of the department of obstetrics and gynecology at the Mayo Clinic, in Rochester, Minnesota.

"Cervical cancer screening is very important, but we are getting smarter at screening," she says. "We are backing off from screening those that have less to gain from it." The cervical guidelines, which recommend that sexually active teens still be counseled and tested for STDs (although a pelvic exam might not be necessary), "hit it right," she says.

Teens who have received human papillomavirus vaccines, such as Gardasil, are protected against several HPV strains that are linked to many, but not all, cervical cancers and to genital warts. These types of vaccines may eventually reduce cervical cancer rates even further (rates have been dropping since the 1970s), although experts say the impact won't be seen for 10 to 15 years. Therefore, girls and women given the HPV shot need to have Pap tests starting at age 21 and every two years after that, just like those who haven't had the shot.

The Centers for Disease Control and Prevention has added Gardasil to its routine childhood vaccine schedule. It recommends that Gardasil, which is administered in three doses, be given to all girls ages 11 and 12, and even for girls as young as 9, with catch-up doses for girls and women ages 13 to 26 who haven't been vaccinated.

"We know that the HPV types targeted by the new vaccine are linked to cervical cancers that tend to occur five years earlier than cervical cancers caused by other HPV types," Gostout says. "So once adolescents are well vaccinated against HPV, we should have even more confidence in eliminating Pap tests in younger women."

Health.com: 10 questions to ask a new partner

"We are now rolling out the vaccine, and clearly the first group that will experience broader protection is young women," agrees the Kaiser Family Foundation's Salganicoff. "The HPV vaccine is a really important step that young women can take in terms of protecting themselves against HPV and subsequent cervical cancer."

Ideally, teens should have an HPV shot and see a gynecologist for counseling about STDs before they become sexually active, experts say. HPV vaccines don't protect women who have already been infected with the virus.

"Ideally, women need to establish a relationship with a reproductive health provider before they become sexually active," Wiesenfeld says.

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Cervical cancer testing guidelines revised

Washington, D.C.

A national physician’s organization has revised its cervical cancer screening guidelines, saying that women in their 20s can have a Pap smear every two years, instead of every year.

The statements follow closely after the start of an ongoing discussion on regular mammograms, stemming from debate on when women should start having the procedure — in their 40s or 50s.

The proximity of the two items has prompted some to worry about a perceived drift toward future health care rationing, fueled by debate over health care reform.

But the American College of Obstetricians and Gynecologists, which released the new cervical cancer guidelines last week, said women younger than 21 are at very low risk of cancer — and screening them may lead to “unnecessary and harmful evaluation and treatment.”

The organization said women should have their first cervical cancer screening at age 21 and can be rescreened less frequently than previously recommended. The new guidelines say most women younger than 30 should undergo cervical screening once every two years instead of annually.

Those age 30 and older can be rescreened once every three years, according to an ACOG news release.

Abilene physician Peter Norton said that in some ways, issues behind the new guidelines stretch back to the 1940s. In 1945, the test gained the support of the American Cancer Society.

Cervical cancer is a slow-growing cancer caused by certain strains of the human papillomavirus (HPV), a common sexually transmitted disease among women and men that also causes genital and anal warts, as well as oral and anal cancer.

“It’s the first time you really know the cause of a cancer — that it’s a virus,” Norton said.

The ability to discover abnormalities earlier, and to find premalignant cells early on, sounds “very logical and very good,” he said.

But in the last 10 years, it’s become known that not all of the infections progress to a cancerous state. So a certain percentage of women may not need to be treated at all, since their own immune systems are able to handle the infection.

“When you couple that with the fact that the cervix is important to maintaining a pregnancy to term, anything that we do to treat premalignant cells might damage the cervix to a certain extent,” he said. “So that becomes an issue.”

All such things considered, Norton worried that because of the suggested guidelines, some patients would be left untreated, leaving them open “to expose other people to HPV.”

“That’s not isolating the disease the way infectious diseases have been traditionally isolated,” he said.

Sexual activity — skin to skin contact, not necessarily intercourse — is what spreads HPV, Norton said.

“We know that there are certain groups of women who probably do not need Pap smears,” he said. “I feel age 21 was used because they feel most girls, probably 60 to 80 percent, are going to be sexually active by the time they’re 18 or 19 years old.”

But that number isn’t accurate for everyone, he said.

Women should start receiving Pap smears three years after the initiation of intercourse, he said.

And for some women, waiting as much as three years between screenings might be “too long,” he said.

Cervical cancer rates have fallen more than 50 percent in the past 30 years in the United States because of the widespread use of the Pap test, according to ACOG, which said in its statement that the majority of deaths from cervical cancer in the U.S. are among women who are screened infrequently or not at all.

Vaccination against HPV is expected to cut cervical cancer rates in the future, but for now, ACOG’s guidelines say vaccinated women should follow the same Pap guidelines as those who are unvaccinated.

Norton dubbed it “interesting” that the guidelines were coming out around the time of the national health debate, though ACOG has said that its similarly timed release is simply coincidental.

Helen Teague, coordinator for women’s health/community initiatives with Hendrick Health System’s Vera West Women’s Center, said she worried that both the breast cancer debate and the revised screening guidelines might herald “the beginnings of the rationing of health care.”

Teague said cervical cancer is preventable with screening and she touted the procedure as safe.

“My question in this whole thing, not only with the mammogram suggestion and now this, is why is it advisable to keep women, in this case, young women, in the dark about their health?” she said. “If we have the technology, why aren’t we using it? Why would we delay in using it?”

An initial cervical cancer screening sets an important baseline for future screenings, she said.

“Most of the folks who make these decisions do not see the faces of those these decisions impact,” she said.

Nationally, some sought to connect the mammogram recommendations to the health-care overhaul, contending that such findings are the way that medical rationing starts.

Under the pending legislation, “nothing would prohibit the federal government from deciding if tests, treatments and procedures are too expensive, and therefore, unnecessary,” Sens. Jon Kyl of Arizona, the Republican Whip, and Tom Coburn of Oklahoma, a physician, said in a joint statement.

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New cervical cancer screening guidelines: No more 'annual' Pap Smear Tests

Washington, D.C.

Doctors Say Young Women Can Wait for First Pap, and Get Them Less Often

Pap smears may no longer be called "annuals" if doctors follow new cervical cancer screening recommendations from the American College of Obstetricians and Gynecologists.

The group announced today that women should start getting cervical cancer screenings at age 21 instead of 18, and that women could wait longer between the screenings -- regardless of when a woman starts having sex.

Women in their 20s with normal Pap smear results now should get screenings every two years instead of every year, and women in their 30s can wait three years between screenings, according to the new ACOG guidelines.

After a week of uproar over the controversial recommendations for less mammogram screenings for women, doctors say they will have to wait and see how the public reacts to the new pap smear guidelines.

"This is not a radical change in screening practices. This is something that's been coming gradually since the 1980s," said Dr. Alan G. Waxman, who helped write the new guidelines.

Some doctors hailed the decision as a way to reduce a host of problems caused by excessive screening; yet, a few others worried it might trigger more women to neglect annual checkups with gynecologists.

Waxman said the move toward fewer screenings will reduce unnecessary treatment in young women and protect them from future pregnancy complications.

On one hand, college-aged women have very high HPV infection rates. Dr. John Curtin, of The Cancer Institute at NYU Langone Medical Center in New York City said 70 percent of all college-aged sexually active people have contracted HPV. These high infection rates translate into a high number of abnormal pap smears.

However, the ACOG guidelines point out that only 0.1 percent of cervical cancer occurs in women under 21 years of age in part, doctors believe, because young women's immune systems are strong enough to fight off HPV before it causes cancer. When dysplasias progress to cancers it's usually a result of older women missing screenings for years at a time; 50 percent of women diagnosed with cervical cancer each year never had a pap smear before, according to the ACOG statement.

And some research has suggested the diagnostic surgery that often follow an abnormal result can pose problems for future pregnancies in some women.

"The driving force behind the change was the numerous studies that show women who are treated for cervical dysplasias are more likely to have a preterm birth," said Waxman, who is a professor at the University of New Mexico in Albuquerque.

Unnecessary HPV Treatment Can Lead to Pregnancy Problems

Waxman explained that the LEEP procedure to remove precancerous tissue often caused by an infection with the human papillomavirus, or HPV, also weakens the cervix. In fact, it's estimated, one in 18 women who've had a LEEP procedure will go on to give birth prematurely.

But, he added, new studies have shown "with most of the cervical abnormalities in adolescents, most of them get better by themselves. ... The thought is that these are the people who have most of their child-bearing years in front of them."

The ACOG recommendations cite studies showing that up to 90 percent of these infections are cleared on their own in adolescents within a few years.

The measure also was intended to reduce anxiety in young women who may struggle with the news that they are infected with a sexually transmitted virus known to cause cancer.

"I was convinced I was dying, that I had cancer. There was not enough education back then," said Nicole C., a resident of La Porte, Texas, who was diagnosed at age 22 with cervical dysplasia -- an abnormal Pap smear -- caused by HPV. "My doctor at the time made me feel horrible about myself, accusing me of not being truthful about how many partners I'd had."

Reducing Anxiety Now and Later On

Nicole, who asked that her last name not be used for privacy reasons, had her first abnormal Pap smear in 1998. As the years passed, more of her friends were diagnosed with cervical dysplasia in their 20s.

As Nicole started serving as an impromptu counselor to explain how HPV is spread, she aimed to soothe fears and reduce the stigma.

"If I had known more back then, I would not have freaked out about it," she said. "I wished they had done that [changed the guidelines] years ago."

Many doctors say they recognize the same anxiety on their young patients' faces.

"Yes, the diagnosis of an abnormal Pap can cause emotional distress to an adolescent girl, and I have certainly seen that," said Dr. Elizabeth Alderman of Montefiore Medical Center in the Bronx, N.Y. "[Cervical biopsies] and repeat Pap smears with visits cost a lot of money."

In fact, some doctors felt the new recommendations did not go far enough.

Dr. Diane Harper of the University of Missouri-Kansas, who specializes in HPV infections, felt that ACOG is behind the other recommending bodies in the United States that argue screening should start at age 25, not age 21.

"There is ample evidence that screening earlier than 25 years is only costly with many false positives," said Harper. "The rest of the world is going to an every-five-or-six-year screening interval ... and ACOG is now just endorsing the three-year interval for HPV negative and Pap negative [women]."

Doctors speaking to ABCNews.com also said they felt the best way to prevent more cancer deaths wasn't to re-screen women who are already seeing doctors regularly, but to try to get women who aren't getting screenings at all into the doctors.

"Whether we screen everybody every two or three years isn't probably not going to make a big difference I don't think, just as long as they are getting screened," said Curtin. "The fact remains there are unscreened patients and they are at risk for cancer."

Doctors speaking to ABCNews.com also said they felt the best way to prevent more cancer deaths wasn't to re-screen women who are already seeing doctors regularly, but to try to get women who aren't getting screenings at all into the doctors.

"Whether we screen everybody every two or three years is probably not going to make a big difference, just as long as they are getting screened," said Curtin. "The fact remains there are unscreened patients and they are at risk for cancer."

Negative Effects of Fewer Pap Smears Unknown

On the other hand, many women admit that the only reason they go to a doctor is for an annual Pap smear and contraception. For those reasons, some doctors worry such women won't receive any medical checkups at all.

"Honestly, the first time it was discovered, I was going to Planned Parenthood for contraception because I had just become sexually active. It was only my second partner," said Alicia, a 32-year-old woman from New Orleans who also did not want her last name used.

Alicia had her first abnormal Pap smear when she was 18.

"I cried, and I really, really freaked out," she said.

But the task of treating her abnormal Pap smears made her aware of her health.

"That was a pivotal moment in my life," she said. "I started doing things better. I started getting into gardening and doing things to calm down."

Dr. Donnica Moore, president of Sapphire Women's Health Group and an obstetrician-gynecologist by training, worried that the new guidelines might keep women who've had a normal Pap smear, or no symptoms, away from the doctor.

"Women may now assume -- incorrectly -- that if they only need a Pap smear every two or three years, then they only need to see their gynecologist every two to three years, and for many of these women, their gynecologist is their primary care physician," said Moore. "Thus, they will not be getting a routine physical, breast exam, blood pressure measurement, and sexually-transmitted infection testing."

Changing Recommendations on Pap Smears
However, Friday's changes aren't the first to affect cervical cancer screenings. Over the years, doctors have scaled back on cervical cancer screening schedules after more research proved less frequent screenings were effective.

"It is about time this occurred," said Dr. Mark Einstein of the Montefiore Medical Center in the Bronx, N.Y. "Oftentimes, young women are put into a 'high-risk' category, clinically, because they have a [positive] Pap test that is essentially just a sign of an HPV infection -- but it is not clinically relevant. This leads to anxiety and over-testing."

Dr. Joanna Cain of Brown University agreed, and argued that the HPV vaccine will further decrease the transmission of the virus that is responsible for up to 70 percent of cancers in the coming years.

Below is a timeline of changes to cervical cancer screenings over the years, according to Waxman:

1957 -- The American Cancer Society runs a nationwide campaign for women to get a Pap test every year.

1976 -- Canadian health leaders examine data and recommend a woman get a Pap smear every two years, after a woman has three consecutive normal Pap smears.

1980 -- The American Cancer Society follows Canadian guidelines recommending a woman get a Pap smear every two years after three consecutive normal Pap smears.

1988 -- The American College of Obstetricians and Gynecologists recommends starting screening at 18, or with the onset of sexual activity and getting a Pap test every year. But after three negative Pap tests, women should be screened less often.

2003 -- ACOG guidelines shift from recommending the first Pap smear at age 18 or the onset of intercourse to age 21 or three years after the onset of intercourse.

2008 -- The American College of Obstetricians and Gynecologists guidelines shift to recommend adolescents who have a minor abnormality on a Pap test wait to get biopsies and a diagnostic test called a colposcopy.

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FDA says Cervarix vaccine blocks cancer-causing HPV virus

Washington, D.C.

A vaccine from GlaxoSmithKline successfully blocks the virus that causes most cases of cervical cancer, the Food and Drug Administration said Friday.

In documents posted online, the FDA said Cervarix — Glaxo's vaccine against human papilloma virus or HPV — successfully blocked the two most cancerous strains of the virus nearly 93 percent of the time.

The main study of the vaccine enrolled more than 18,000 women who either received Cervarix or a sham treatment. The FDA said the vaccine appears to fight the HPV virus for more than six years, based on company data. Side effects were minor, such as pain and swelling at the injection site.

The agency will ask a panel of vaccine experts next week whether Cervarix should be approved for girls and women ages 10 to 25. The FDA is not required to follow the group's advice, though it usually does.

A positive review from the agency will clear the British drugmaker's vaccine to compete in the U.S., though it could face an uphill battle against Merck's blockbuster vaccine Gardasil, which has been on the market here since 2006.

Besides having a three-year head start, Gardasil also defends against two more HPV types that cause 90 percent of genital warts, something Cervarix does not target.

Cervarix already is approved in nearly 100 other countries, but has been delayed in the U.S. since 2007 when the FDA said it needed additional data.

Earlier studies of Cervarix showed a higher number of muscular and neurological problems among patients who used the vaccine compared with the alternate treatment.

The FDA said Friday it asked outside experts to examine more recent data from the company to see if Cervarix could have caused those problems.

"The conclusion in the case of each of these efforts was that the data are not sufficient to establish a link," the agency said in its review.

The FDA said it would ask Glaxo to report any continuing problems in a follow-up study planned for after the vaccine's launch.

About 6 million people in the U.S. each year contract HPV, which usually causes no symptoms and clears up by itself. While there are about 40 strains of the virus that are spread through sexual contact, only about 15 cause cancer in men and women.

Last year nearly 4,000 women died of cervical cancer.

"Protection against cervical cancer is a very important health need for girls and young women, and we believe Cervarix has an important role to play in addressing this," said Glaxo spokeswoman Lisa Behrens.

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New report shows Tennessee's policies to prevent cervical cancer are falling short

Chattanooga, TN

According to a new report, Tennessee is falling short in its legislative efforts to combat cancer. How Do You Measure Up?: A Progress Report on State Legislative Activity to Reduce Cancer Incidence and Mortality evaluates each state’s legislative activity on six issues key to winning the fight against cancer. Developed by the American Cancer Society Cancer Action Network (ACS CAN), the advocacy affiliate of the American Cancer Society, the report finds that Tennessee met none of the benchmarks set for six issues.

“Our state legislators can play an important role in the war against cancer by passing legislation that can help reduce the toll this disease takes on our state and save lives,” said Bill Evans, an ACS CAN volunteer. “We all have a responsibility to fight back against a disease that kills 13,340 in Tennessee each year by enacting laws and policies that eliminate barriers for the proper diagnosis, treatment and care of cancer patients.”

How Do You Measure Up? details state efforts around health care coverage, prevention and quality of life measures. The report measures state policies (as a result of a legislative vote or a ballot initiative) on six specific issues: breast and cervical cancer early detection program funding; access to care for the uninsured; colorectal screening coverage laws; smoke-free laws; pain management; and tobacco taxes. A color-coded system is used to identify how well a state is doing. Green represents the benchmark position with well-balanced policies and good practices; yellow indicates moderate movement toward the benchmark and red shows where states are falling short.

In addition to the specific areas that were rated, the report also examines how states are measuring up on issues such as the affordability of health coverage on the individual market or through Medicaid for low-income populations. It also details state efforts to fund tobacco prevention and cessation programs and as well as state investments in nutrition and physical activity promotion.

“As advocates, we have the responsibility to educate the public on the many ways to prevent and fight cancer effectively at the state level, but we cannot do it unless state and local policymakers take action,” said Mr. Evans. “In most cases, the solutions we offer will save the state millions of dollars in health care costs and increased worker productivity. In many cases, it costs the state little or nothing to do the right thing.”

This past legislative session, volunteer advocates worked to pass comprehensive colorectal cancer screening legislation that would have created the framework for a screening program for the underserved and would have required insurance companies to cover colorectal cancer screenings. However, the proposed legislation got rolled over to the second half of the legislative session, which begins in January 2010.

How Tennessee measures up:
Breast and Cervical Cancer Early Detection Program Funding: Yellow

The Uninsured: Red

Colorectal Screening Coverage Laws: Red

Smoke-free Laws: Red

Pain Management: Red

Tobacco Taxes: Red

Throughout the past year, state legislatures across the country have made great advances in the fight against cancer. In the last year, 12 states and the District of Columbia have passed or implemented tobacco tax increases, bringing to 46 the total number of states with tobacco tax increases since 2002. Six more states implemented comprehensive smoke-free laws, protecting workers and patrons from the hazards of secondhand smoke. And many states are working on policies and programs to reduce cancer risk related to poor nutrition, lack of physical activity and obesity.

In addition, many state legislatures fought hard to preserve coverage for lifesaving cancer screenings and treatments and to stave off attempts to cut state funds that support these programs, such as the National Breast and Cervical Cancer Early Detection Program.

In 2009, more than 1.4 million people in the United States will be diagnosed with cancer and more than 562,000 people will die from the disease. In Tennessee this year, 32,570 people will be diagnosed with cancer and another 13,340 will die of the disease.

For state-by-state details or a copy of the complete report, please visit www.acscan.org.

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Delaware cervical cancer rates drop

Wilmington, DE

A report released Friday by Delaware's Division of Public Health shows cancers rates in Delaware are declining. The state compared cancer statistics from 2001 through 2005 to numbers from 1991 through 1995.

The state said overall cancer rates are down five percent from a decade ago. The state said the number of men diagnosed with lung cancer has dropped 20%.

The report also showed cancer death rates have declined 17%. The biggest improvement came in the death rates from cervical cancer. The state said that rate fell by 31% over the last decade.

"It's great news, and on top of that our racial disparities are declining or being eliminated," said Lisa Henry of the Division of Public Health.

State officials said the decline is due, in part, to an increased number of cancer screenings, which can detect cancer early before it has a chance to spread.

Henry said the state will continue to offer free cancer screenings and to try and increase public awareness to drive cancer rates down even further. The state also offers free cancer treatments to qualified families. The Division of Public Health said hundreds of people have already been helped by the program.

The state said even with the decline, cancer rates in Delaware remain higher than the national average. However, Delaware's cancer rates are falling faster than the national rates.

For more information on Delaware cancer screenings, call 1-800-464-HELP.

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Cervical cancer: A young mother's story

Atlanta, GA

A young Cobb County mother says she has a story she wants parents to hear. At 29, Rachel Chastain is fighting for her life against cervical cancer and Tuesday, she shared her story.

Chastain has had a rough year, trying to balance being a mother with chemotherapy, radiation, and surgery.

Chastain has been blogging about her experience with cervical cancer. Viewers can read more about her story by going to her Caring Bridge blog: www.caringbridge.org/visit/rachelchastain.

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Surgical treatment of cervical cancer

Kansas City, MO

There are several different types of treatment for cervical cancer. Surgery is a way in which cervical cancer can be treated and there are many different types of surgery that can be used. The type of surgery used depends on several factors as well as the stage of the cancer. Most patients will still need some form of radiation and/or chemotherapy even if they do undergo some type of surgery for cervical cancer.

Treating Cervical Cancer Through Surgery: Laser Surgery

This type of surgery is done as an outpatient procedure in cases where the cancer hasn't spread. During this surgery as laser is used to “vaporize” any abnormal cells. This type of surgery is not able to be used in those with invasive cervical cancer.

Treating Cervical Cancer Through Surgery: Cryosurgery

This surgery is used when the cancer is still within the cervix. The cancer cannot have penetrated cervical tissues to a deep layer either. During this procedure liquid nitrogen and a probe are used to freeze any abnormal cervical cells in order to kill them.

Treating Cervical Cancer Through Surgery: LEEP

This type of surgery is used when the cancer has not spread. This procedure involves using a wire that is heated by electricity to remove any abnormal tissues.

Treating Cervical Cancer Through Surgery: Simple Hysterectomy

This surgery is done when cervical cancer has yet to spread further than the uterus. During this procedure the cervix and uterus are removed. They can be removed through the abdomen (incision) or through the vagina.

Treating Cervical Cancer Through Surgery: Radical Hysterectomy

Once the cancer spreads further than the cervix this surgery may be performed. During this procedure the cervix, uterus, upper vagina, ovaries, parametrium, fallopian tubes and all or some of the local lymph nodes are removed. After this surgery a woman will need to undergo hormone replacement therapy to alleviate the symptoms of menopause.

Treating Cervical Cancer Through Surgery: Pelvic Exenteration

This surgery is very rarely performed and it is extreme. It involves removing the same organs that are removed in a radical hysterectomy plus additional organs. Other organs that may be removed include the vagina, the rectum and the bladder. External bags may be needed to collect rectal and bladder waste if these organs are removed. In some cases the healthy sections of the colon can be reconnected so that the patient does not need an external bag to collect waste. Vaginal reconstruction may be done if the vagina is removed. This surgery is only used in very rare and extreme cases of cervical cancer.

For More Information:

http://www.ehealthmd.com/library/cervicalcancer/CC_treatment.html
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Cervical cancer spot turns theatre into giant cervix

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Vancouver, BC

It's not as bad as it sounds. To encourage women to get regular Pap smears, and to promote its Cervical Cancer Screening Program, BC Cancer Agency partnered with Cineplex Odeon Theatres to air "Eye of the Cervix" in theatres.

Friendly enough ad. The curtain opens to reveal a pretty, congenial doctor. She asks if we're comfortable, does a quick swab and decisively says, "And we're done."

Closing lines bring it home: "It doesn't take long to prevent cervical cancer. Remember to have regular Pap tests."

We like it just fine, and it even made us feel productive, but here's where wanky boyfriends turn to their partners and go, "When was the last time you got checked?"

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Cervical cancer- shame and fear?

Seattle, WA

Thanks to the new HPV commercials the general public is now aware that cervical cancer can be caused by an STD. They urge more people to be tested and vaccinated, yet now that it has been added to the ‘dirty disease’ category like HIV and AIDS will less women be tested or comfortably admit their diagnosis? It’s sad that we live in a judgmental world. Cancer is cancer no matter where it is on your body. Breast cancer carried the same hush-hush stigma not so long ago and more women lost their lives going undiagnosed or diagnosed too late.

Not all patients with cervical cancer had HPV. In the words of a 33 year old woman who underwent a radical hysterectomy to save her life, “I have no family history of cervical cancer; I’ve never had any STDs; I haven’t had multiple sex partners; and I don’t HPV. Perhaps, when people are aware that one has cervical cancer, they won't look at it as being a "dirty woman" disease like my family did.”

No one deserves cancer. No one battling cancer deserves to be treated with anything but love and compassion. Remember, any STD can occur with just one time, just one partner. Yes, the risk increases with more partners but the reality of infidelity, or an unknowing infected partner can lead to HPV.

The Seattle Cancer Care Alliance advises, “Regular Pap tests are important to your survival: about 90 percent of women whose cervical cancer was detected by a Pap test will survive. The figure is much lower--only 40 percent--for women whose cancer was not diagnosed until they experienced vaginal bleeding.”

According to the American Society of Clinical Oncology, possible symptoms are:

• Blood spots or light bleeding between or following periods


• * Menstrual bleeding that is longer and heavier than usual


• * Bleeding after intercourse, douching, or a pelvic examination


• * Pain during sexual intercourse


• * Bleeding after menopause


• * Increased vaginal discharge

Be informed, be supportive and never live in fear or shame when your life or their's is on the line.

Find a Gynecologic Oncologist: http://www.wcn.org/findadoctor/ Gynecologic oncologists are specially trained to care for women with gynecologic cancers such as cervical cancer, endometrial, or uterine cancer, or ovarian cancer.

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Pap Tests and menopause

Atlanta, GA

A Pap test, or Pap smear, is a pelvic exam that checks the cervix fluids and cells for possible cancer and precancerous cells. Typically they are given to every woman of childbearing age after they become sexually active to check for cervical cancer and other items. These tests help in finding precancerous cells early so that there is a greater chance of treatment options that will work for the survival of the patient. But what about those out of childbearing years, those in menopause? Should they still be getting a yearly Pap test?

Getting the Pap Test
Those getting a Pap smear should prepare two days in advance so that they can get the best possible result, mainly an accurate one that will not do false results. Things that a woman should not be doing for two days prior to the Pap smear pelvic exam are:
Do not have sex
Do not take tub baths
Do not use douches, artificial lubrication, or feminine hygiene products
Don’t use tampons (don’t even have a Pap smear while on your period)
Do not use foam, cream, or jelly birth control
Don’t use vaginal medication or creams

Pap Smears and Menopause
Usually women can stop having a yearly pelvic Pap smear exam after reaching age 70 if they meet one condition. They must have had the past 10 years of normal Pap Smear results. They are still asked to have pelvic exams, but the pap smear doesn’t need to be included.
If the woman goes into early menopause prior to the age of 70, it is usually recommended that they continue to get one to test for the cervical cancer risk. After reaching the age of 70 they will then be able to relax the need for pap smear pelvic exams if the woman has had normal results for the prior 10 years of testing.

How often a woman gets a pap smear is completely up to many different things. Whether or not she has a history of cancer, her age, whether she smokes, or if she has HPV (human papillomavirus) are some of those factors that will increase her need for more frequent pap smears and other pelvic exams. But if the woman continues to have a thorough exam and get normal results, they will relax the need to see her as often as before. The need for early detection is still key in having these types of tests.

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Smoking is independent risk factor for cervical cancer in women with oncogenic HPV types: Presented at IPV

Malmo, Sweeden

New research confirms that smoking is an independent risk factor for cervical cancer in women with oncogenic human papillomavirus (HPV) types, researchers stated here at the 25th International Papillomavirus (IPV) Conference.

"We must emphasise cervical cancer prevention among women exposed to tobacco smoke," said Aline Simen-Kapeau, PhD, National Institute for Health and Welfare, Oulu, Finland, on May 12.

The researchers noted that the strong correlation between smoking and exposure to oncogenic HPV types makes determining the independent role of smoking in cervical carcinogenesis difficult. This study was designed to determine that role.

Data from 5 large Nordic country serum banks with samples from >1 million people were correlated to national cancer registries (1973-2003).

The researchers retrieved serum samples from 588 women who developed invasive cervical cancer and 2,861 matched control subjects.

The serum samples were analysed for cotinine and antibodies to oncogenic HPV types 16 and 18, herpes simplex virus type 2, and Chlamydia trachomatis.

The risk of squamous cell carcinoma (SCC) of the cervix was found to be associated with smoking among heavy smokers in the HPV16-/HPV18-seropositivegroup (odds ratio [OR] = 2.7; 95% confidence interval [CI], 1.7-4.3).

After adjustment for HPV16/18 antibodies, a similar risk of cervical cancer was found among heavy smokers (OR = 3.2; 95% CI, 2.6-4.0).

The risk increased with older age at diagnosis and with increasing cotinine levels.

"This study confirms that smoking is an independent risk factor for cervical cancer in women infected with oncogenic HPVs," the researchers concluded.

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Warning signs of cervical cancer

Selma,AL

New information regarding cancers flashes across televisions screens nearly weekly. Recently, though, the human papillomavirus has come to the forefront because it links cancer to sexually transmitted diseases.

There are more than 80 types of HPV, and certain types can cause cervical cancer. In fact, HPV is the most common cause of the disease.

Research scientists are still learning about cervical cancer and others everyday. According to the National Cancer Institute, 11,070 new cases of cervical cancer were found in 2008. The cancer caused 3,870 deaths.

“Cervical cancer seems to have come into the spotlight lately because of all the commercials for vaccines,” said Luella Giles, health initiative representative at the American Cancer Society’s Montgomery office. “Some states like Texas and California are requiring girls to get the vaccination.”

The Guardasil vaccination can be administered to females from nine to 26-years-old. This vaccine prevents four types of HPV. Two can cause cancer and two can cause genital warts. Two symptoms of cervical cancer that should raise a red flag are abnormal vaginal bleeding and increased vaginal discharge.

“If women think there is a possibility they have a problem, then it is better to go to a physician and get checked,” said UAB Director of Gynecologic Oncology Dr. Ronald D. Alvarez. “Waiting never helps the problem.”

The National Cancer Institute lists risk facts of developing cervical cancer. Some are obvious — HPV infection and smoking — while others are lesser known — seven or more full-term pregnancies and long-term use of oral contraceptives.

There are several ways to prevent being infected with HPV. Included among them is avoiding sexual activity, getting vaccinated and using another means of birth control.

Early detection can be achieved through regular pelvic exams and Pap tests to find abnormal cells.

If there is any sign of cancer, the physician will typically use a coloscope — a bright light with a magnifying lens to make tissue easier to see — or perform a biopsy.

According to the National Cancer Institute, there are four ways to perform a biopsy. The punch biopsy uses a sharp tool to pinch off a small sample of the cervical tissue. In a LEEP the doctor uses an electric wire loop to slice off a thin, round piece of cervical tissues. The doctor uses a curette, a small, spoon-shaped instrument, to scrape a small sample of tissue from the cervix in an endocervical curettage. The doctor removes a cone-shaped sample of tissue during a conization, or cone biopsy, which lets the pathologist see if abnormal cells are in the tissue beneath the surface of the cervix. The doctor may do this test in the hospital under general anesthesia.

“If you are concerned about which biopsy is the best, then ask your doctor,” said Giles. “Don’t forget that you have every right to ask for a second opinion.”

If cervical cancer is detected, there are three routes of treatment — surgery, radiation and chemotherapy. A physician may see it fit to use a combination of the three.

After successful treatment, the battle isn’t over. Many survivors join support groups to let each other know they are not alone.

“Support groups are just one way to get back to normal life,” said Giles. “Cancer does not have to be stop your day-to-day life.”

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