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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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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Cancer screening guidelines for women questioned

Washington, D.C.

Recent changes in women's cancer screening advice stunned some local health care providers.

Last week, a recommendation issued by the U.S. Preventive Services Task Force said women should generally begin getting routine mammographies at age 50, instead of 40.

The American College of Obstetricians and Gynecologists also recommended limiting cervical cancer screenings to women ages 21 and older, regardless of their sexual history.

Local medical officials question the logic that these new recommendations will prevent unnecessary anxiety and false alarms among younger women.

Wayne Young, director of Battle Creek Health System's The Cancer Care Center, said women in their 40s who are given mammographies are more likely to detect breast cancer at an early stage when it is more treatable.

A mammography is not 100 percent accurate, but it is the best early detection tool physicians have, he said. Abnormal results can be followed with needle biopsies and further tests for cancer.

"It's a little discomfort for some women; for others it will save their lives," he said.

Young said his mother and sister died of breast cancer before age 50. His three daughters will be screened early because of their genetic link, but he wanted all young women to get the best preventive treatment available to them as soon as possible.

His biggest concern is that health insurers will follow these agencies' recommendations and retract coverage for screening younger women, he said.

"That will become an issue because, especially in this economy, that will be an extra out-of-pocket cost and some people will put it off until age 50," he said.

Dr. Kari Formsma, a Battle Creek gynecologist and obstetrician with Pathway Women's Health, said she is concerned about the recommendation to limit cervical cancer screenings regardless of women's sexual history.

She said the guideline fails to acknowledge child sexual abuse and teenage promiscuity.

Cervical cancer is caused by certain strains of the human papillomavirus. It is a sexually transmitted infection that a condom cannot protect against. A woman's risk of developing cervical cancer increases with the number of sexual partners she has.

o it doesn't make sense to say a 21-year-old virgin is at more risk of getting cervical cancer than a 12-year-old victim of sexual abuse who has had multiple partners before age 21, she said.

The American College of Obstetricians and Gynecologists issued the recommendation because cervical cancer takes an average of five years to develop. But that assumes women don't begin having sex until they are 16, Formsma said.

She agreed with the task force's recommendation against teaching breast self-examinations on the grounds that it is often more harmful than not. Women who perform self-exams are more likely to find and be treated for benign lumps, according to the research.

"Breast self-exams, I tell patients to do them if they feel like it," she said. "I'd rather them do things that are a clearly proven benefit, like exercising every day."

She also applauded the move away from annual cervical cancer exams to every two years for women with normal Pap tests.

The money spent on unnecessary exams would do more good testing sexually active teens for infections, she said.

Overall, Formsma recommended patients disclose their full sexual history with their doctor to know how high a risk they have of developing cervical cancer, and then schedule screenings on an individual basis.

Young said the same is true for women in their 40s who are concerned about breast cancer. Women who have a family history of breast cancer or a genetic predisposition should consult their doctor about getting earlier screenings.

"A woman just needs to check with her primary care physician because those people ... can recommend whether she should get a mammogram or not," he said.

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Pap Smear Test guidelines changed: Fewer Pap Tests advised for women in 20's

Washington, D.C.

Most women in their 20s can have a Pap smear every two years instead of annually, say new guidelines that conclude that's enough to detect slow-growing cervical cancer.

The change by the American College of Obstetricians and Gynecologists comes amid a separate debate over when regular mammograms to detect breast cancer should begin. The timing of the Pap guidelines is coincidence, said ACOG, which began reviewing its recommendations in late 2007 and published the update today in the journal Obstetrics & Gynecology.

The guidelines also say:

— Routine Paps should start at age 21. Previously, ACOG had urged a first Pap either within three years of first sexual intercourse or at age 21.

— Women 30 and older should wait three years between Paps once they have had three consecutive clear tests. Other national guidelines have long recommended the three-year interval; ACOG had previously backed a two- to three-year wait.

— Women with HIV, other immune-weakening conditions or previous cervical abnormalities may need more frequent screening.

Paps can spot precancerous changes in the cervix in time to prevent invasive cancer, and widespread use has halved cervical cancer rates in the U.S. in recent decades. About 11,270 new cases will be diagnosed this year, and about 4,070 women will die from it, according to American Cancer Society estimates. Half of women diagnosed with cervical cancer have never had a Pap, and another 10 percent haven't had one in five years.

Cervical cancer is caused by certain strains of the extremely common sexually transmitted virus called HPV, for human papillomavirus. There is a new HPV vaccine that should cut cervical cancer in the future; ACOG's guidelines say for now vaccinated women should follow the same Pap guidelines as the unvaccinated.

But the updated guidelines reflect better understanding of HPV. Infection is high among sexually active teens and young adults. Women's bodies very often fight off an HPV infection on their own without lasting harm, although it can take a year or two. The younger the woman, the more likely that HPV is going to be transient.

Moreover, ACOG cited studies showing no increased risk of cancer developing in women in their 20s if they extended Pap screening from every year to every two years.

As for adolescents, ACOG said cervical cancer in teens is rare — one or two cases per million 15- to 19-year-olds — while HPV-caused cervical abnormalities usually go away on their own, and unnecessary treatment increases the girls' risk of premature labor years later.

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Liquid-Based Cytology Is Not Superior to the Conventional Papanicolau (Pap Smear) Testing

A recent research featured in the October edition of the Journal of the American Medical Association presents a Dutch investigation that studied approximately 90,000 women who underwent the Papanicolau test.

The investigators state that the liquid-based cytology which represents an alternative to the traditional Papanicolau test provides no advantage in comparison with the latter in finding pre-cervical cancer symptoms or the actual disease.

The medical world thought the Papanicolau test to be under the detection standards because it sometimes provided false- positive or negative results for the patients who underwent it. Regarding the usage of body cell entitled liquid-based cytology, the cells coming from the cervix are gathered thorough the use of a common sampling gadget and are put into a vial containing some preservation substance compared to the process of putting the sample on a glass slide, a thing which was used in the past. However, even if this represents a new detection method, various researches showed that the accuracy of the detection was not always a certain fact.

The team of scientists undergoing the investigation was led by Albertus Siebers from the Radboud University Nijmegen Medical Centre located in the Netherlands state Nijmegen. He and his colleagues started the research by comparing the screening accuracy of the Papanicolau tests and the liquid-based cytology. They looked at the positive results rate, the histological detection ones and the PPVs (positive predictive values). The investigation had a random character and comprised a number of 89,784 females who aged between 30 years and 60 years. All of the women were included in a screening process for cervical cancer which comprised 246 family Dutch clinics. From these family practices, 122 used liquid-based cytology and verified 49,222 women and the rest of the medical facilities used the traditional Papanicolau testing and verified 40,562 women. The females were controlled for CIN (cervical intraepithelial neoplasia) and were monitored for eighteen months until January. This took place in the year 2008.

The group of investigators discovered that the adjusted detection rate for cervical intraepithelial neoplasia garde 1+ was of 1.01, for the cervical intraepithelial neoplasia grade 2+ it was 1, for cervical intraepithelial neoplasia grade 3+ it was 1.05 and for carcinoma, the ratio was 1.69. As the investigators explain, this adjusted ratio did not vary very much from one for certain results of cervical intraepithelial neoplasia in the cases of some cytological call-off.

Due to the random character of the investigation, it can be thought that the propensity of cervical intraepithelial neoplasia was the same for both of the tested samples. This is why the inexistence of variation in the detection ratios and the positive predictive values during the specific research proved that the liquid-based cytology is not more sensitive or more accurate in discovering the cancer affecting the cervix compared to the traditional Papanicolau method.

The scientists concluded that there was not a significant variation in the positive rates provided by the cytological testing mechanisms. However, the evidence provided by this innovative detection process does not bring enough proves to state a similar accuracy in diagnosing women who suffer from cervical cancer. The analysis comprising the intent to treat and the way in which doctors can do this showed that the liquid-based cytology was not better than the Papanicolau test in the matter of finding positive rates of the already studied under the microscope results.

The same outcome came from the positive predictive values. In conclusion, the evidence provided by the investigation states that if the cytological testing is done in a very organized and qualitative screening for cervical cancer process, it does not differ from the traditional Papanicolau test.

Mark Schiffman and Diane Solomon, both medical doctors from the National Cancer Institute state their opinion regarding this research. Nowadays, being a doctor involved in the prevention of the cervical cancer seems to be a very challenging position. Even if the methods and tools used in the cervical detection process are updated and come in high numbers, no corroboration of vaccines, humanpapilloma virus tests, cytology, colposcopy and innovative ways would apply in the same way for all the women. They state that if we deal with areas around the Globe in which the health rates and quality of life are very high, the vaccines, liquid-based cytology or humanpapilloma virus tests could be a waste of resources if they are not taken out in a planned manner.

In addition, the medical doctors believe that the research undergone by Siebers team has made things simpler in the means that those persons involved in cervical cancer screening, monitoring and treating can use one of the two detection methods: the traditional Papanicolau test or the liquid-based cytology. Even if this decision-making process became more complex at the moment when the cytology appeared on the health market, the investigators managed to make the doctors see the exact role of this new detection method in applying treatments to their patients.

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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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Cervical cancer screening should continue after 50

HemOnc Today

Data from an observational prospective study of the incidence of cervical cancer indicates that age is not a good discriminative risk factor for early cutoff of cervical cancer screening. Researchers found that the risk for cervical cancer, even after several negative cervical smear tests by the age of 50, was still similar to that of women of younger ages.

The researchers analyzed data from a Dutch national registry of histopathology and cytopathology. They compared data from 218,847 women aged 45 to 54, and 445,382 women aged 30 to 44 at the time of a third negative smear test.

After 10 years, 105 women had developed cervical cancer within 2,595,964 woman-years at risk in the 30 to 44 age group, and 42 within 1,278,532 woman-years at risk in the 45 to 54 age group.

The incidence rate of cervical cancer was similar in both age groups at 41 per 100,000 (95% CI, 33-51) for the 30 to 44 years age group vs. 36 per 100,000 (95% CI, 24-52) in the 45 to 54 age group.

The findings suggested it would not be consistent to stop screening these women while also not relaxing the screening policy for younger women with similar screening histories, according to a press release.

“Our conclusion lends support to the current cervical cancer screening guidelines in England and other developed countries, which do not discriminate women by age up to 60 to 65,” the researchers wrote.

Modern computer technology may allow for individually tailored screening invitations, according to Björn Strander, MD, director at the Cervical Screening Oncology Center at Sahlgren’s University Hospital in Göteborg, Sweden.

“We have to pay close attention to developments in invasive cancer in age groups above the cut-off point for screening and be prepared to adjust the screening ages as we learn more,” he said in an accompanying editorial.

Rebolj M. BMJ. 2009;doi:10.1136/bmj.b1354.

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New advanced DNA test could make pap smears obsolete

Lufkin, TX

Annual pap smears could soon move to medical history books. Dr. Kay Carter said the new advanced dna test could save women's lives. "It can tell whether the DNA is high risk or low risk DNA for the HPV virus," said Dr. Carter.

She said the DNA test will make gynecologists' jobs easier. That is because it is a one step screening process

"If a woman has a high risk HPV virus then we will automatically go directly to biopsies and test that gives us more accurate information than the pap smear screen does," said Dr. Carter.

Dr. Carter believes most women get an annual pap smear out of routine and don't really understand its purpose. "I don't think that women classically understand the pap smear and why we have to do it," said Dr. Carter. She said the new DNA test makes it easier to understand that there is a virus that causes cervical cancer and women need to be checked for that virus.

Women over 30 could drop the annual pap smear and instead get a DNA test every three, five or ten years. The women we talked to said the pap smear does not bother them. "It's better to be safe than sorry, waiting three years is a long time, once a year is pretty accurate," said Becca Tatum, patient.

"You're going to have to come in for a yearly exam anyways, a breast exam, a pelvic exam so you mine as well get the pap smear done while you are," said Wendy Burger, patient.

Dr. Carter said over time, the DNA test will also cut yearly medical expenses.

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Testing key to preventing cervical cancer

Bainbridge, GA

With early detection and screening and a vaccine that protects against human papillomavirus (HPV), health care professionals have the tools they need to prevent cervical cancer, says Southwest Health District Health Director Dr. Jacqueline Grant.

Noting that Cervical Cancer Awareness is marked in January, Grant explained that it takes years for precancerous cervical changes to progress into cancer.

“A Pap test can detect changes in the cervix that can be treated before they become cancer,” she said.

Also known as a Pap smear, the test involves taking a cell sample from the cervix or vaginal cuff using a small cervical brush and/or wooden scraper.

In addition, a vaccine is available to protect against HPV, the sexually-transmitted virus that is usually responsible for precancerous and cancerous changes in the cervix, said Grant.

“The vaccine can prevent most cervical cancers,” she said. “It can be given to girls and women 9 through 26 years of age. Studies have shown the vaccine is safe and very effective.”

However, Grant stressed that receiving the HPV vaccine is not a substitute for having routine cervical cancer screenings.

“You increase your risk of developing cervical cancer if you aren’t getting a regular Pap test,” she warned.

Other risk factors include smoking, beginning sexual activity at an early age, being sexually active with several partners, failing to use condoms, having a sex partner who has had multiple partners, having a history of precancerous changes in the cervix and having HIV or another condition that suppresses the body’s ability to fight off disease.

“It’s important to understand that having a hysterectomy or being past child-bearing age doesn’t mean you should automatically stop having Pap tests,” Grant warned.

She recommended that:

• Women should have their first Pap test within three years of the onset of sexual intercourse, but no later than 21 years of age; testing should be done yearly until age 30.

• Beginning at age 30, women who have had three normal Pap tests in a row may get tested every one to three years (at the discretion of their physician).

• After age 70, patients may choose to stop having Pap tests (after discussing it with their physician), if three or more recent tests are normal, and there have been no abnormal results in the last 10 years.

• After a total hysterectomy, discuss with your physician whether it is necessary to continue having Pap tests.

“Early on, cervical cancer usually does not cause signs and symptoms,” said Grant.

“Advanced cervical cancer may cause bleeding or discharge from the vagina that is not normal for you, such as bleeding after sex. If you have any of these signs, talk to your health care provider. They may be caused by something else, but the only way to know is to see your health care provider.”

For more information about Pap tests or the HPV vaccine in Southwest Georgia, please contact the Decatur County Health Department at 248-3055 or go online to www.southwestgeorgiapublichealth.org.

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Baltimore County offering free Pap tests

Baltimore, MD

In honor of January being Cervical Cancer Awareness Month, the Baltimore County Health Department is offering free Pap tests, mammograms and breast exams for eligible women between 18 and 65.

The department also screens for eligibility, schedules appointments and manages the cases of women with abnormal test results.

About 11,000 women in the United States are diagnosed with cervical cancer each year, and more than 3,500 women will die from the disease. A Pap test, which is recommended annually, is one of the most effective ways to detect cervical cancer, health officials said.

For more information on these free tests, call 410-887-3432 or visit baltimorecountymd.gov/go/cancerprogram.

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Free cervical cancer screening this month in La Porte, IN

La Porte, IN

La Porte Regional Health System will offer free cervical cancer screenings in November.

Preregistration is required due to limited availability.

Screenings will be available in LaPorte from 4 to 7 p.m. CST Nov. 20. For more information or to register, call (219) 326-2073. Spanish-speaking individuals should call (219) 325-4629.

The American Cancer Society estimates that about 11,070 cases of invasive cervical cancer will be diagnosed in the United States in 2008. The most important step in being aware of cervical cancer is having regular cervical screenings. Women should consider the free screenings if they are between the ages of 20 and 65, have not had a Pap test in a year or more and have not had a hysterectomy.

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What does an abnormal Pap Test mean?

Tampa Bay, FL

Nearly every day, I see patients who have received an abnormal Pap test result in my gynecology office. These abnormal results can trigger tremendous anxiety, so I spend significant time educating my patients about what the results may mean.

A Pap test, or Pap smear, looks for changes in the cells of the cervix that may indicate cervical cancer or other conditions that could develop into cancer. Cervical cancer is the third most common gynecologic cancer in the United States, after endometrial (first) and ovarian (second) cancers. If caught early, cervical cancer can be cured. A Pap test, part of a woman's routine physical exam, is a very effective screening tool for detecting precancerous conditions and small tumors that can lead to cervical cancer.

Women are advised to begin Pap tests about three years after becoming sexually active or by age 21. The tests are usually performed yearly, unless you are told otherwise by your physician. If no dysplasia (pre-cancer) or cancer of the cervix is detected, the result comes back negative. If your doctor says your result was "abnormal," it means the test found some cells on your cervix that do not look normal - it does not necessarily mean you have cancer. In fact, the likelihood that a woman with an abnormal Pap result has cancer is actually quite low. There are other causes for abnormal Pap results, including human papilloma virus, other types of infections and natural cervical cell changes related to menopause.

An AS-CUS Pap, otherwise known as atypical squamous cells of unknown significance, means that the laboratory detected some abnormalities, but cannot exactly classify the changes. Many physicians will ask the lab to further test this specimen for high-risk HPV - certain types of HPV associated with cervical cancer. If a woman with an AS-CUS Pap also tests positive for high-risk HPV, low-grade intraepithelial lesions (LSIL), high-grade intraepithelial lesions (HSIL), or atypical glandular cells of unknown significance (AGUS), she will be advised to undergo a colposcopy to further evaluate the problem.

A colposcopy allows the physician to look more closely at a woman's vagina and cervix with a lighted magnifying device. A vinegar solution is often applied to bring out changes on the cervix. If abnormalities are found, a cervical biopsy may be performed.

Depending on the woman's age and health and the severity of the abnormality, observation or treatment may be recommended. Most women with HPV or low-grade lesions will be watched closely, since these types of abnormal cell changes frequently go away on their own over time. They will repeat a Pap test every six months for several years and resume yearly screening only when the precancerous condition resolves.

Women with moderate to severe cell changes or persistent low-grade dysplasia are often advised to undergo a cervical conization. This procedure, performed in the office or an operating room, removes a cone-shaped piece of abnormal tissue from the cervix and cervical canal. It may be used to diagnose cervical cancer or to treat a cervical abnormality.

If you are notified that your Pap test is abnormal, follow your physician's instructions for follow-up and testing frequency. Make sure to find out the results of your Pap test, even if they are negative.

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Even if you've had HPV cervical cancer vaccine, Pap smears are still necessary

Fredricksburg, VA

SINCE its introduc- tion in 2006, the human papilloma virus (HPV) vaccine has been given to millions of girls and women between the ages of nine and 26. As a result, the incidence of abnormal Pap smears is already on the decline. And the number of follow-up tests--such as cervical biopsies--and treatments--like cryotherapy--is also declining.

This is great news, but it shouldn't lull women into a sense of complacency.

HPV, as the name indicates, is a virus. It is passed from one person to another by direct contact, like sexual intercourse.

Once a person is exposed to the HPV virus, one of three things can happen:

The immune system may get to work clearing the virus from the body, and it will never cause any problems.

The virus may enter the cells of the external genital organs like the vulva, vagina or cervix and just lie dormant, causing no detectable disease for an indefinite period of time.

Or, the virus may cause changes to the cells it inhabits that can lead to pre-cancer or, over time, cancer.

PAP SMEAR POWER

There are about 40 different types of HPV that can infect the human genital tract. The current HPV vaccine protects against only four: the two types that cause approximately 90 percent of genital warts, and the two types that cause 70 percent of cervical cancers.

That means that this vaccine does not protect against HPV types that cause the other 30 percent. There's a new HPV vaccine coming down the pike that will cover more types, but it still won't cover all 40.

It's important to understand that just because you've had the HPV vaccine, this doesn't mean that you can be lax about having Pap smears. Even for the vaccinated group of women, Pap smears are still a very important tool for the early diagnosis of pre-cancer and cancer of the cervix.

So, what are the most recent recommendations for cervical cancer screening?

First of all, Pap smear testing should begin at least three years after the onset of sexual activity or at 21 years of age, whichever comes first. After this, Pap smear testing should occur yearly until the age of 30.

Read more, "Even if you've had HPV cervical cancer vaccine, Pap smears are still necessary"

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New cervical cancer test beats pap smear

London, UK

A new way to test for cervical cancer is more accurate than a pap smear and identified more dangerous lesions, an Italian study showed on Tuesday.

Researchers used the traditional test for the human papilloma virus that causes cervical cancer and combined it with another that indicated specific cancer-causing activity in cells, said Guglielmo Ronco, a cancer epidemiologist at the Centre for Cancer Prevention in Turin, who led the study.

A simple test for a protein called P16INK4A provided a biomarker showing cell changes that indicated a woman likely has pre-cancerous lesions, Ronco and colleagues reported in the journal Lancet Oncology.

"The marker shows there was some sort of disruption by the HPV virus," Ronco said. "Only a small minority of women who have an HPV infection actually develop cancer. The challenge is to find out who are at higher risk of developing cancer."

Cervical cancer is the second most common type of cancer in women. Each year an estimated 500,000 women are diagnosed with the disease and about 300,000 die from it, mostly in the developing world.

Merck & Co's Gardasil and GlaxoSmithKline's Cervarix are vaccines that protect against some strains of the virus.

More countries are also adopting screening tests, but the problem is pap smears produce too many false positives -- meaning women get a test that suggests they have potentially cancerous or pre-cancerous changes when in fact they do not.

An HPV test looks for the virus while in a pap smear doctors scrape cells from the cervix and examine them under a microscope for abnormalities that could indicate precancerous lesions.

"Most HPV infections simply regress without causing disease," Ronco said in a telephone interview. "They disappear spontaneously, which is the reason there are so many false positives."

The Italian team collected cervical cell samples from women who had already tested positive for the HPV virus, most of whom had already undergone an expensive colposcopy exam -- a close examination of the cervix using a magnifying instrument.

Then they tested for P16INK4A protein in more than 1,100 of these women and found that it helped identified 88 percent of those who had the cancer-causing lesions with far fewer false positives. The protein is more active in cervical-cancer cells.

The refined test also identified 50 percent more of the dangerous lesions than pap smears and required fewer women to be referred for colposcopy, Ronco said.

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Massachusetts hospital offers free ThinPrep Pap Test cervical cancer screenings

Norwood, MA

On Tuesday, Sept. 9, Caritas Norwood Hospital will offer free cervical cancer screenings. Dr. June S. Chun of the hospital’s Obstetrics/Gynecology Department and Small Miracles Family Birthing Center will conduct the screenings.

Dr. Chun will use the ThinPrep Pap Test, a liquid-based test that employs a fluid transport medium to preserve cells, eliminate debris and distribute a representative portion of cells on a slide in a uniform, even layer. The ThinPrep Pap Test is approved by the FDA as “significantly more effective” than the conventional Pap smear for the detection of low-grade and more severe lesions, thereby increasing the opportunity to detect and treat cervical abnormalities earlier.

According to American Cancer Society estimates, nearly 11,150 women in the United States were diagnosed with cervical cancer in 2007 and about 3,670 died of the disease. Cervical cancer is almost 100 percent curable if detected early.

Dr. Chun is a member of the American Board of Obstetrics and Gynecology and is in practice with Dr. John Al-Jamal and Margaret Duggan, Nurse Practitioner at Caritas Ob/Gyn of Walpole.

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Pap smear after 70 up to patient, doctor

Orlando, FL

Question: I am 75. During my last checkup, my gynecologist said I do not need to continue getting Pap smears. This has me concerned as I have done this faithfully all of my adult life. Is it safe to stop?

Answer: This question cannot be answered for you in a column such as this. Only a doctor who does Pap smears and knows you can tell you if it is safe to stop or not. I can, however, try to provide you with some information and context that may help you take this question back to your doctor.

"Pap" stands for Papanicolaou, the name of the doctor who developed this test in the 1940s. Until then, we had no good screening test for cervical cancer, one of the most common cancers among women. The cervix is the opening of the uterus into the vagina.

This is an excellent screening test -- simple and relatively painless, inexpensive, and very sensitive and specific. Countless lives have been saved by this simple test. Medicare pays for Pap smears every other year, but this might not continue.

The Pap smear is done during routine pelvic examinations. A device called a speculum is inserted into the vagina to aid exposure and the surface of the cervix is scraped to obtain cells. These are examined under a microscope for abnormalities.

Pap smears can detect the earliest changes in cervical cells preceding the development of cancer. This offers the possibility of treatment options other than a hysterectomy -- removal of the entire uterus and cervix -- in cases such as when younger women wish to preserve the ability to conceive.

In 2006, new Pap smear guidelines came out. According to these, women at low risk can probably discontinue having Pap smears after 70. Women qualifying as low risk should have had regular Pap smears for years preceding that birthday with no abnormalities. They also should be sexually abstinent or in a mutually monogamous, long-term relationship. One reason for this is the association of cervical cancer and human papilloma virus (HPV), a sexually transmitted infection.

It is important to emphasize that not needing a Pap smear does not mean you can avoid regular pelvic examinations. These are more than just a means of doing a Pap smear. They check for pelvic tumors, ovarian cancer and other pelvic problems. A rectal examination is part of a pelvic and checks for problems in that area.

Women who might not need a Pap smear include those who have had a total hysterectomy, which includes removal of the cervix. Sometimes, however, Pap smears might be advisable even in the absence of the cervix, such as when there might be precancerous changes in the wall of the vagina itself. When a partial hysterectomy is done, the cervix is preserved and taking a Pap smear with the pelvic exam should still be done.

This is not an exhaustive list of who does and who does not need a Pap smear. Ultimately, the decision to discontinue Pap smears should be made between you and the physician who knows you best.

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J. Matthews, MD: Pap Test Explained

Muskogee, OK

If you were asked to conjure up one phrase to represent what gynecologists do with their time day in and day out, what could you come up with? If you’re like most of my patients, you would immediately reply “Pap smear.”

How many of you, though, could explain just what a Pap smear consists of, or what its purpose is? This just isn’t a topic that often gets tossed around at casual lunches or over coffee.

The Pap smear is a medical test which is actually one of the most effective cancer-screening methods ever devised. It’s done by removing some cells from the surface of the cervix with a plastic “spatula” or brush. These cells are then sent to a pathologist, a doctor who specializes in microscopic examinations of tissue.

What the pathologist looks for are changes in the cells that are abnormal, changes that are referred to as dysplasia, which is significant because it can signal the first steps in a transformation to cervical cancer. That is what makes this test so useful: it detects changes in cells before cancer has begun.

Many women, when contacted by a doctor about an abnormal Pap smear, incorrectly conclude that they already have cervical cancer. Fortunately, this is very rarely the case. Cervical cancer tends to develop very slowly, and so women who have annual Pap smears can find precancerous changes early and get treatment before cancer strikes.

The Pap smear has been around for many decades, and for most of that time it has been our best weapon against the fifth most deadly women’s cancer worldwide. The incidence of invasive cervical cancer has dropped more than 50 percent since Pap smears began to be widely used.

In just the last few years, though, two new weapons have appeared which may eventually make the Pap smear obsolete. That doesn’t mean that your gynecologist can start throwing away all of those speculums, but we may be able to drive the number of deaths from cervical cancer even lower than it already is.

Doctors now know that cervical cancer is almost exclusively caused by a virus, called the human papilloma virus: HPV for short. This fact makes it fairly unique among cancers. Unlike breast cancer, ovarian cancer, colon cancer, or almost any other cancer, cervical cancer could potentially be defeated.

In the meantime, you should be checking your memory for the date of your last encounter with that speculum. If it’s been more than a year, give your doctor a call.

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Pap test awareness: Pap-A-Thon promotes women's health

South Bend, IN

It's an important test that could save a woman's life, a pap smear. But many don't have the tests done either because their too busy or don't have healthcare.

That's why the Women's Task Force at St. Joseph Regional Medical Center held a "pap-a-thon" Wednesday.

They performed free pap tests and enrolled women in need in a federal program that provides free healthcare.

Joan Lennon from the Women's Task Force says, "We are helping woman, many woman, young mothers often, who just don't have the resources or they have to put their children first and are not able to come in and get their screenings or other woman who find themselves without health insurance which happens to be a large population of our society today.

The tests were held at eight different sites across Michiana Wednesday. Nearly a thousand woman were tested.

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Pathologist lobbies congressman for local lab testing of Pap smear tests

Local lab makes its pitch when congressman comes calling.

Fredricksburg, VA

With a congressman in the house, Dr. Paul Hine lobbied for his laboratory.

His message: "The best practice is local practice."

Hine is chairman of the Department of Pathology and Laboratory Medicine at Mary Washington Hospital. Yesterday he and the laboratory staff hosted 1st District Rep. Rob Wittman, a Republican from Westmoreland County.

The Fredericksburg hospital officials talked with Wittman about federal funding for the Medicaid program, and about the testing requirements for laboratory technologists.

But the focus was on the benefits to patients of using a local, rather than national, laboratory. And to illustrate, the staff demonstrated for Wittman how it reviews Pap smears.

A Pap smear checks for cervical cancer and is usually part of a woman's annual gynecological exam.

Specimens are collected in doctors' offices and sent to laboratories such as Mary Washington's. There, slides are prepared and examined under high-powered microscopes.

A technologist peers through the microscope to find any abnormal cells. Hine compared it to hovering in a helicopter over a mall parking lot.

"Your task is to find which, if any, cars have left their doors open," he said.

Some of the slides are chosen randomly for a second look, and abnormal ones are checked by a pathologist.

"Over 50 percent of all slides are read by more than one person," Hine said.

The Pap test is seen as an effective way to identify abnormal cells that can become cancerous. Hine said it has been more than a year since he saw a slide from a patient with invasive cancer.

"The reduction in women's cervical cancer is phenomenal," he said.

Mary Washington's laboratory reviews 5,000 Pap tests each year. Yet that represents only 10 percent of the local market.

The rest are sent by doctors' offices to national laboratories such as LabCorp and Quest Diagnostics.

Patients have little choice in where the laboratory work is done. Health insurance companies, such as Anthem, believe they can get quality work at a lower price by contracting with national laboratories.

But Hine and Cindy Huffman, laboratory director, argued that patients and physicians benefit from the interaction that occurs at a local laboratory.

Huffman said it is common for a doctor to call or walk into Mary Washington's lab and ask the staff, "Can you pull this slide?"

"We believe quality is best measured by local knowledge," Hine said. "We're accountable to people in this community."

Wittman did not offer an opinion on the use of national laboratories, though he did appear comfortable in the hospital laboratory. He has an undergraduate degree in biology and worked for 26 years in the seafood safety division of the Virginia Department of Health.

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Dear Dr. Donahue: Pap smear results, simply translated

Pap smear results, simply translated

DEAR DR. DONOHUE: Give me some information on HPV and ASCUS. I don't know if I have HPV, but my doctor told me to come back in six months for a repeat Pap smear.

Few medical tests have made such a profound impact on reducing cancer statistics than has the Pap smear. It detects abnormal cells early so that the appropriate treatment also can be started early. Since the introduction of the Pap smear, mortality from cervical cancer has been cut in half.

ASCUS means "atypical squamous cells of unknown significance." "Atypical" indicates that the cells aren't exactly normal but that they aren't cancer cells, either. Squamous (SKWAY-mus) cells are the cells that line the cervix, the ones that can become cancerous.

In translation, your report says you have some strange-looking cells that aren't cancer but aren't normal. The usual approach to this situation is to repeat the smear in three to six months. By that time, harmless changes should have cleared.

HPV — human papillomavirus — is the cause of cervical cancer. No cancer changes were seen. No evidence of HPV was noted. If you were infected, your doctor would not have hesitated to tell you so. All you have to do is make sure you have the repeat test so the issue can be cleared up once and for all.

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Examining the reason behind frequent Pap-smear tests

Examining the reason behind frequent Pap-smear tests

"Good luck, fellas," the attractive receptionist called out to us with a knowing grin as we filed into the office of Dr. Mons, the gynecologist who was to be the preceptor to four, third-year male medical students.

"Now, boys," Mons began, "it is important to understand that gynecology is a very . . . well . . . it's a sensitive area. It is vital that you appreciate how a woman feels under these circumstances."

He then proceeded to ask the studliest of this group to hop up onto the examining table. I explained my knee was sore and so Brad said he would do it. He jumped onto the table and, with a smirk, slipped his heels into the stirrups. "Sorry, Brad, but that's not terribly realistic. Remove your pants."

A little shaken, he tentatively removed his drawers. "Now assume the position," Mons ordered.

After a bit of coaxing, he finally reset himself in the stirrups and, as instructed, lay back on the table, no longer chuckling. Then, in a move I'll not soon forget, this wise/abusive specialist taught us a lesson for the ages.

"Cheryl!" he announced into the speaker. "You can come in now."

As the door opened and the receptionist appeared, Brad strained several muscles, a few organs and the richest part of the "Hallelujah" chorus as he scrambled to find some protective modesty-preserver in the room.

He succeeded in partially wrapping several torn pieces of paper off the exam table around his torso. To this day, I have nothing but the highest respect for the procedure a woman has to go through in order to have a Pap smear.

In 1935, George Papanicolaou of Cornell University discovered that by taking a wee scraping from the cervix (opening to the womb), he was able to determine if pre-cancerous cells were brewing. Before Dr. Papanicolaou's developing of de test that women detest, cervical cancer killed more women than breast or lung cancer. Before the Pap smear, cervical cancer was the leading cause of cancer death in women.

Consider these facts:

1. In 1999, 14 women died of cervical cancer each day in the U.S. and Canada.

2. 85 per cent of them had not had routine Pap smears.

3. Every 21/2 minutes, a woman on this planet dies of cervical cancer.

4. Because of a lack of screening facilities, cervical cancer is the leading cause of cancer death in women in Third World countries.

5. 15,000 women in Canada and the U.S. will be diagnosed with cervical cancer this year.

It is imperative that the Pap test, the most effective of all cancer screening tests, is not neglected.

Age 12 to 17 - There's no need to have the test before age 18 unless the girl is sexually active. If she's having sex, then her risk of contracting the HPV virus, that leads to cervical cancer, is high and she requires annual pap smears.

Age 18 to 50 - Annually. After three consecutive normal pap smears and assuming only one partner, the test can move to every two years.

Age 50 to 100 - Even though post-menopausal, the same criteria currently apply.

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ThinPrep Pap Test and imaging system, cervical cancer screening

Chillicothe, Ohio

New equipment to provide earlier, more accurate cervical cancer diagnosis

Adena Health System Wednesday began use of a new, advanced cervical cancer screening system that is designed to improve efficiency and performance of the screening process.

The new ThinPrep Imaging System is the first fully integrated, interactive computer system to assist lab professionals in the primary screening of ThinPrep Pap Test slides. The system combines revolutionary imaging technology with medical experts' ability to interpret the results to improve cervical cancer screening efficiency and performance.

"Adena Regional Medical Center is committed to providing our patients with the most advanced technology to detect disease early, and the ThinPrep System enables us to do that," said Dr. Byron Smith, pathologist at Adena. "Using this system offers significant improvements over previous screening technologies. Making this technology the standard in our practice was simply the right thing to do."
The ThinPrep Pap Test is a liquid-based test that uses a fluid medium to collect and preserve cervical cells. Specimens are first collected by the clinician with a cervical sampling device in the same way as is done now. Instead of smearing the cells on a slide, however, the device is rinsed into a ThinPrep vial containing a fluid that captures virtually all of the cells. The specimen is then sent to the laboratory where a ThinPrep Processor eliminates debris and distributes a uniform, representative thin-layer of cells on a microscope slide. The ThinPrep System improves the quality of the specimen, which can result in more accurate diagnoses and fewer unnecessary repeat tests.

According to the National Cancer Institute, about 15,000 women in the United States are diagnosed with cervical cancer each year and about 5,000 die of the disease. Cervical cancer is almost completely curable if detected early.

More than 30 published studies with more than 500,000 patients have demonstrated the improved performance of the ThinPrep system when compared to the conventional Pap smear. A study published in the American Journal of Obstetrics and Gynecologyconcluded that the ThinPrep improves diagnosis of low-grade and high-grade precancerous cell abnormalities compared to the conventional Pap smear. The article also demonstrated improved sample adequacy. Currently, about 70 percent of all Pap tests in the U.S. utilize the ThinPrep Pap Test.

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Harvard Medical School cervical cancer/pap smear Q&A

More On Cervical Cancer/Pap Tests

Answered by Dr. Chris Awtrey, Division of Gynecologic Oncology, Beth Israel Deaconess Medical Center and Dr. Hope Ricciotti, Obstetrician/Gynecologist, The Dimock Center.

Q: What is cervical cancer?

The cervix is the lowest part of the uterus (womb) and connects it to the upper vaginal canal. Cancers of the cervix generally develop from the lowest portion where the uterus and the vaginal canal meet. Cancers are either described as squamous, which are similar to skin cells or glandular (adenocarcinoma) which are similar to mucus secreting cells of the gastrointestinal tract. In the United States there are estimated to be over 11,000 cases diagnosed in 2007 and 3,670 women will die of the disease. Cervical cancers do not develop quickly from normal cervical cells but gradually go through a progression from a precancerous state to cancer, a process which occurs as a result of exposure to the human papillomavirus (HPV). Thankfully, only a fraction of patients with precancers of the cervix, a condition known as cervical dysplasia, develop cancer.

Q: Can cervical cancer be prevented? How?

There are two ways to prevent cervical cancer. The first is to avoid exposure to the human papillomavirus (HPV) either by not engaging in intercourse or limiting the number of partners. Condom use also reduces the risk of getting HPV. Another good way of preventing the disease is to be vaccinated to the subtypes of HPV known to cause 70% of the precancerous condition (dysplasia) and the cancer. The HPV vaccine Guardasil is now available for women 26 and under. Because cancer of the cervix generally develops slowly and progresses through a precancerous state known as dysplasia, identifying and treating precancerous changes through the use of pap testing cervical is the other way to prevent cervical cancer. Cells from the cervix can be sampled at time of pelvic exam using a pap test, which can identify precancerous cells of the cervix.

Q: How do you screen for cervical cancer?

Screening for cervical cancer is performed at the time of annual pelvic exam by using a pap test. We can sample some of the cells of the ectocervix, where these cancers generally develop and identify precancerous microscopically. This is how we identify a change before a real cancer develops. The biology of cervical cancer is that it happens to have a long (many years) precancerous phase, and that is why cervical cancer screening has been so successful

Q: What exactly is a Pap test?

A Pap test is a sampling of the cells of the cervix using a brush or small, narrow scraping paddle. It is the most effective cancer screening tool that physicians have to prevent cancer. Sampling does not harm the cervix and for women having a pelvic exam the sampling is generally not a painful process and is well tolerated. Since we have been using Pap tests, the incidence of cervical cancer has dropped dramatically. Now, with the HPV vaccine, it should go even lower.

Q: Who should get a Pap test and how often?

The general rule is that women who are sexually active or have been in the past should be screened for cervical cancer starting three years after the onset of sexually activity, or by age 21, on a yearly basis. Once a woman has a series of normal pap tests for three straight years, this testing interval can be increased. However, this should only be done after consulting with your health care provider.

Q: What is the liquid-based Pap test?

Pap tests originally were performed by smearing the cells removed from the ectocervix on a glass slide. Recent innovations have revolutionized the old pap smear and now practitioners in the U.S. generally use the new liquid-based test. This essentially replaces the glass slide. Now, the cells are taken from the brush and floated into a liquid preservative. This allows for less clumping of the cells on a slide and removes debris and mucus from the sample, which made the old pap smears harder to read. Data on this new liquid-based technology shows that it reduces the number of tests needed to be repeated due to unclear sampling and may even increase the pick-up rate of cancers and precancers. HPV testing is also done as part of the liquid pap test, which adds to our ability to decide which pap test results need treatment.

Q: Are cervical cancer vaccines approved by the FDA?

Cervical cancer vaccines are vaccines against the HPV virus sub-types that are associated with development of cervical dysplasia and cancers. The vaccine Guardasil is FDA-approved and is given as a series of three injections over six months, and ideally should be given to women prior to potential exposure to HPV, for example, before starting to have sexual intercourse. So it is currently recommended for young girls ages 9-11. However, it is FDA approved through age 26, and we are therefore doing “catch up” vaccines for young women to get them vaccinated.

Q: Who should receive the vaccine?

At this point the American Cancer Society recommends that the vaccine be given to girls age 11-12 and as early as age 9, at the discretion of a pediatrician. Older women up to age 26 should be counseled on receiving vaccination and are eligible to have catch-up vaccination. It is unclear if women older than 26 benefit from the vaccine. There is another vaccine awaiting FDA approval that will have a higher age cut-off.

Q: What is the age cut-off for receiving the vaccine?

At this point, the cut-off for receiving the vaccine is 26. Insurance will not cover the cost of the vaccine if you are older than 26.

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Free cervical cancer screening to be offered at Southwest Virginia Cancer Center on April 19

Cedar Bluff, VA

An estimated 15 thousand new cases of cervical cancer will be diagnosed in the United States this year.

Regular testing is very important because there are no symptoms in the early stages of cervical cancer.

By undergoing an annual pelvic exam, a woman can help ensure any abnormalities are detected early.

The Southwest Virginia Cancer Center will offer free cervical screenings to area women Saturday, April 19th from 9AM - Noon.

Participants must pre-register to receive the free screening. For more information or to register, call The Wellmont Nurse Connection at 1-877-230-NURSE.

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QIAGEN focuses new HPV test ad campaign on real-life story of woman's escape from cervical cancer

Germantown, MD

Jodi McKinney, mother of five and wife of nearly 20 years, was recently diagnosed with cervical disease. Fortunately, she was able to be treated before it became cervical cancer -- thanks in part to her physician's decision to order an HPV test along with her Pap. Despite her initially normal Pap smear, the HPV test found that Jodi had a high-risk type of the human papillomavirus -- the primary cause of cervical cancer. Now, Jodi, her entire family and her physician are the focus of a new television campaign launched by QIAGEN to share what Jodi learned about cervical cancer prevention with other women across America. QIAGEN is the developer of the digene HPV Test, the only FDA-approved test for HPV.

View the entire TV ad featuring Jodi McKinney and her family sharing the message about the importance of HPV testing at http://tinyurl.com/4owquc

The ad tells of the scare first experienced by Jodi, her husband Patrick and her five children, and of the happy ending that has allowed Jodi to tell her story today. It is now being broadcast in selected cities across the country. The TV ad can be viewed online as well.

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HPV Vaccine Reduces Abnormal Pap Test Results

Birmingham, AL

A significant drop in abnormal Pap test results was seen after girls and women were given a human papillomavirus (HPV) vaccine to prevent cervical cancer, according to a researcher at the University of Alabama at Birmingham (UAB), Birmingham, Alabama.

These findings, presented on March 10 at the annual meeting of the Society of Gynecological Oncologists in Tampa, Florida, show the HPV vaccine (trade name Gardasil) appears to prevent the development of cell changes that lead to cervical disease. In testing, the vaccine reduced abnormal Pap test results by 43% compared with women not given the vaccine. The 43% reduction was for tests that found precancerous changes called high-grade squamous intraepithelial lesions (HSIL) more than 3 years after women were given the vaccine.

The HPV vaccine also reduced other abnormal Pap results, including milder premalignant cell changes, by 16% to 35% compared with women not given the vaccine. These findings are not definitive that the HPV vaccine prevents cancer; however, they do signal that the vaccine will spare thousands of women a diagnosis of cell abnormality or malignant changes that may lead to more tests and possibly surgery.

"Clearly the vaccine's benefits include something that can be appreciated by women and daughters fairly quickly," said Warner Huh, MD, Associate Professor, UAB Division of Gynecologic Oncology, and the physician chosen to present the data. "This is a positive first sign, and it will take many more years to know definitively if the vaccine prevents cancer."

The results are a compilation of 3 separate trials involving more than 18,000 women aged 16 to 26 years in the United States, Europe, and Asia. All test subjects had normal Pap smear readings at the start of the trial.

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Study: HPV DNA Test better than Pap Smear for cervical cancer screening

Denver, CO

It's a relatively new test with new research backing up its benefits and if you fit the right profile you may be able to only have a Pap smear once every three years.
It's the HPV DNA test used to detect cervical cancer-- a cancer that is diagnosed in about 10,000 women in the U.S. each year.
A Canadian study found out of 10,000 women the HPV test correctly found 95 percent of the lesions that could develop into cervical cancer while the Pap test found 55 percent

But that doesn't mean women can say so long to the swabbing of the cervix, you still have the Pap test. The HPV is just another test using the same sample from the Pap.

Dr. Chris Carey at Denver Health Medical Center said the HPV test can also provide women peace of mind. "If Pap smear is mildly abnormal and HPV is negative, then a woman doesn't have to have a coloposy or biopsy." More >>

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January is cervical cancer awareness month

York County, Maine

January is Cervical Cancer Awareness Month, and the Southern Maine Medical Center (SMMC) is reminding women to have a Pap test, especially if they have not had one in several years.

Cervical cancer is nearly 100 percent curable when caught in the earliest stages, and regular Pap tests save lives, SMMC stated in a press release.

SMMC is collaborating with the Maine Breast and Cervical Health Program to provide ongoing screenings at no cost to women who qualify. Maine women between the ages of 40 and 64 who are without health insurance may qualify for a free Pap test and mammogram under this program.

Cervical cancer is the easiest gynecological cancer to prevent through regular Pap tests and a new vaccination, when applicable, SMMC said. Although cervical cancer remains a leading cause of death in countries where Pap tests are not available, in the United States deaths from cervical cancer have declined dramatically — by 80 percent — since the introduction of the Pap test in the 1940s. This sharp drop in deaths is directly attributed to the Pap test, which detects abnormal cervical cells even before they develop into cancer. Once detected, the cells can be removed, preventing women from developing cancer of the cervix.

Most invasive cervical cancer is found in women who either have not had a Pap test in five or more years, or have never had a Pap test. In 2007, an estimated 11,000 U.S. women were diagnosed with cervical cancer and 3,600 died from the disease, according to the press release. Many of these deaths could have been prevented through early detection with a simple Pap test.

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Cervical cancer prevented by routine check up

Boone, NC

It is as painless as brushing your teeth, but most women fear it more than midterms, a first date and stepping on the scale after the holidays combined.

By either age 21 or three years after the onset of sexual activity, every female should have her first visit to the gynecologist.

Appointments are available through Student Health Services for pap smears and sexually transmitted infection
screenings.

Students can schedule appointments for as early as the following day.

Appointment times are either during health service operation hours or from 4:30–7:30 p.m. after hours.

A pap smear is $30 and STI tests are free.

Sarah E. Summers, family nurse practitioner at Student Health Services, recommends women to schedule appointments.

“Screening for cervical cancer is a reason why women should go,” Summers said. “[Screening] doesn’t take much time, it’s cost effective, there’s only mild discomfort and it’s the only way to screen for cervical cancer.”

Summers said after the initial exam, a pap smear should be conducted once every year until the age of 30.

At that point, going once every two to three years is probable.

“The risk for human papillomavirus (HPV,) which causes cervical cancer, drops after the age of 30,” Summers said.

Health services offers Gardasil, a vaccination for the virus, for $125 per injection. Three injections are required for a complete vaccination.

“Women in third world countries who don’t have annual pap smears die from cervical cancer,” she said. “The United States should never have a death from cervical cancer.”

In 2004, more than 11,850 women were diagnosed with cervical cancer, and over 3,800 women died as a result.

That same year, over $2 billion was spent treating the disease, according to the Center for Disease Control and Prevention. More >>

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Cervical cancer prevention campaign comes to Oklahoma

Oklahoma City, OK

Oklahoma's Jari Askins is the latest lieutenant governor to sign onto a program intended to encourage women to learn more about cervical cancer prevention and detection.

The campaign encourages women to get Pap tests and be vaccinated against the human papillomavirus that causes many cervical cancers. The HPV vaccine is recommended for girls who are 11 or 12 years old.

Officials expect about 160 Oklahoma women to be diagnosed with cervical cancer and another 60 to die of the disease this year. More >>

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Cervical cancer prevention efforts: Pap test and HPV vaccine

Washington, DC

In the United States, cervical cancer remains a disease of socioeconomic disparity, with Hispanic and African-American women more likely to be diagnosed with the disease and more likely to die of it than white women.

An HPV vaccine was approved by the FDA in 2006 for girls and women aged nine to 26 and studies show it is 100 percent effective at preventing disease from the HPV types that account for 70 percent of all cervical cancers and 90 percent of genital warts. A second HPV vaccine, shown to be as effective against cervical cancer-causing HPV, is currently under review by the FDA.
Even with the HPV vaccine, screening will still be critical to protect women against cervical cancer caused by HPV types not covered by the vaccine, for women already exposed to HPV types targeted by the vaccine, and for women who
do not receive the vaccine. Research shows that the Pap test is 51 to 85 percent accurate, depending upon the type of Pap test used. An FDA-approved HPV test is available and research shows that adding HPV testing to a Pap test in women aged 30 and older can increase a clinician's ability to identify women needing early intervention and a major study recently found that the HPV test as a stand-alone screen was almost 40 percent more accurate than the Pap test and recommended that HPV testing be used as a primary, frontline screen.

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National Cervical Cancer Coalition Stresses Importance of Screening and Prevention During January Cervical Health Awareness Month

December 27, 2007 (Van Nuys, CA)

Women Urged to Take Action and Protect Themselves in New Year

Approximately 10,000 American women will learn they have cervical cancer/HPV this year, and nearly 4,000 will die from an advanced form of the disease. This January, during Cervical Health Awareness Month, the National Cervical Cancer Coalition (NCCC) is focused on educating women about the importance of the Pap test as a screening tool for cervical cancer/HPV and about vaccines that can further reduce the burden of this devastating disease.

It's the start of a new year - a time many reflect on their health. To start the year right, we encourage women to contact their health care provider to schedule a Pap test to check for cervical cancer. This screening is a crucial part of a woman's health care regimen, yet one that many overlook. "It's important to remember that cervical cancer is a preventable disease - as long as it's caught early enough," says Ms. Sarina Araujo, Executive Director of the NCCC.

While routine administration of Pap tests is the best means of detecting cervical cancer at an early stage, vaccines have the potential to protect women from the disease, by targeting cancer-causing types of the human papillomavirus (HPV). HPV, a virus transmitted through sexual contact, is the single known cause of cervical cancer. Two forms of the virus, HPV 16 and HPV 18, account for more than 70 percent of all cervical cancer cases. Some medical experts believe that through a successful education, screening and vaccination program for women, we will have the potential to nearly eliminate cervical cancer in the U.S.. More >>

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Reasons Pap Tests Used More Than HPV Tests for Cervical Cancer Screening

USA Today Examines Reasons Pap Tests Used More Than HPV Tests for Cervical Cancer Screening [Nov 02, 2007]

USA Today on Thursday examined the reasons Pap tests remain the top cervical cancer screening tool despite some recent studies that found human papillomavirus tests to be "superior" tools (Rubin, USA Today, 11/1). According to two studies published last month in the New England Journal of Medicine, HPV tests were more accurate than Pap tests in the detection of cervical cancer and precancerous changes in the cervix.

For one of the studies, Canadian researchers led by Eduardo Franco of McGill University performed an HPV test and a Pap test on 10,154 women ages 30 to 69. The HPV test detected 95% of cases in which participants had precancerous changes in the cervix, compared with 55% for the Pap test, the study found (Kaiser Daily Women's Health Policy Report, 10/19).

According to USA Today, about 60 million Pap tests are performed annually in the U.S., and "switching to screening with only an HPV test would represent a sea change in women's health care." The "most obvious roadblock" toward greater HPV testing in the U.S. is that a test manufactured by Digene is the only HPV test approved by FDA, and it is approved only to be used in conjunction with a Pap test or as a follow-up screening, USA Today reports. In addition, a clinical trial to prove that screening with the HPV test will lead to lower mortality rates "might be prohibitively costly and time-consuming," according to USA Today.

Some researchers said that other reasons Pap tests remain the top cervical cancer tool include malpractice concerns, marketing of Pap tests, and reluctance among many physicians and women to not use the Pap tests, according to USA Today. Walter Kinney, a cytologist at Kaiser Permanente in California, said that even if HPV testing were approved as a stand-alone primary screening tool, convincing physicians and patients of its efficacy would be a challenge (USA Today, 11/1).

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Pap tests key to cervical cancer prevention

Natural Medicine: Pap tests key to cervical cancer prevention

Is it time for your annual exam? Annual pelvic exams are an important step toward reducing the chance of developing cervical cancer. Over the past 30 years, regular women's exams have significantly decreased the incidence of cervical cancer in many population groups studied in the United States.

Pap tests are one of the best cancer screening tests available, and one of the key reasons that annual exams are recommended by physicians. A Pap test uses a bristled tool to loosen the first layer of cells off the cervix in a procedure not often felt by the patient. A pathologist then examines these cells to determine the health of the cervix, and monitor any unusual cellular changes. Today, it is estimated that approximately 99 percent of changes caused to the cervix are due to the human papilloma virus (HPV). While these changes may take several years to progress to cancer, treatment is most effective and least invasive if the cellular changes are identified early. More >>

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Cervical Cancer Screening: Too Many Are Left Unprotected

Science Daily — The decline in cervical cancer is a success story of cancer research. Although there are reasons to be optimistic about even further decreases in cervical cancer incidence, there still remain some women who are not screened.

A meta-analysis by Spence and colleagues published in Preventive Medicine shows that undergoing Pap smears irregularly or never was the primary explanation for the development of invasive cervical cancer, followed by false negative tests and poor follow-up of abnormal results.

Papanicolaou and Traut first reported the usefulness of the Papanicolaou smear (''Pap test") for detecting neoplastic cervical cells in 1943. A smear of cells of the uterine cervix indicating the progression of the cancer's growing malignity provided a powerful screening tool that became rapidly used after WWII without its efficacy being evaluated in a randomized control trial. In the United States, the Pap test is credited with having halved the annual cervical cancer incidence rate (from 17.2 to 8.0 per 100,000) and mortality rate (from 6.2 to 2.9) from 1973 to 1999.

In 2000, 83% of U.S. women age 18 and older who had not had a hysterectomy reported having had a Pap test within the past 3 years. The recent discovery of a vaccine against human papillomavirus (HPV), the main cause of cervical cancer, opens the way to the primary prevention of the disease.

The natural history of cervical cancer progression combined with the availability of an HPV vaccine and an effective screening test indicate that eradication of the disease is a plausible objective. More >>

Pap Smear Malpractice Lawsuits

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