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(HealthNewsDigest.com) – Augusta, Ga. – Cervical cancer used to be one of the most common causes of cancer death for American women, according to the American Cancer Society. However, between 1955 and 1992, the death rate declined significantly due to an increase in cervical cancer screenings.
The traditional screening method for women is the Pap test, a procedure in which cells are scraped from the cervix for examination under a microscope. This magnified look at the cells can uncover conditions such as infection or inflammation. But more importantly, the Pap test can detect cancer or changes that may lead to cancer.
More recently, the U.S. Food and Drug Administration approved two vaccines that are safe and effective in the prevention of HPV (human papillomaviruses): Gardasil® and Cervarix.® These vaccines are highly effective in preventing persistent infections with HPV types 16 and 18, two high-risk HPVs that cause nearly 70 percent of cervical cancers. The Gardasil vaccine also prevents infection with HPV types 6 and 11, which cause about 90 percent of genital warts, or papillomas. In addition, there is initial evidence that the Cervarix vaccine provides partial protection against a few other HPV types that can cause cancer.
In general, cervical cancer tends to occur in midlife, with most cases found in women younger than 50. However, 20 percent of women diagnosed are over age 65. In the United States, cervical cancer occurs most often in Hispanic women; at a rate that is more than twice what is seen in non-Hispanic white women. African-American women develop cervical cancer about twice as often as non-Hispanic white women.
As with other cancers, the sooner it is suspected or discovered, the better the chances for successful treatment. Still, more than 4,000 cervical cancer cases diagnosed in 2010 were thought to be fatal. This underscores why regular screening and vaccines, when applicable, are so important.
Oncologists at the MCGHealth Cancer Center encourage women from ages 10 to 26 to complete a three-dose HPV vaccination schedule over six months to safeguard their health. Furthermore, they recommend routine cervical cancer screening using American Cancer Society guidelines.
According to the ACS, all women should begin screening about three years after they begin having vaginal intercourse, but no later than age 21. Screening should be done every year with the regular Pap test or every two years using the newer liquid based Pap test. In a liquid-based Pap test, the cells are rinsed into a small container of liquid before being examined under a microscope.
Beginning at age 30, women who have had three normal Pap test results in a row may reduce screening to every two to three years. The American College of Obstetricians and Gynecologists released guidelines in August 2003 recommending that women 30 years or older be offered an HPV DNA test in addition to their Pap smear and pelvic exam. DNA testing for HPV has gained widespread acceptance as an additional cervical cancer screening tool and as follow-up to abnormal changes detected with a Pap smear.
If the HPV DNA test and Pap smear are negative and the woman does not have an underlying health condition, then the guidelines suggest that she may wait three years before having another Pap smear and HPV DNA test. Patients who are positive for high-risk HPV, have abnormal cell changes on their Pap smear, or have underlying medical conditions should be screened more frequently, with the frequency to be determined by the patient and her doctor on an individual basis.
Women 70 years of age or older who have had three or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years may choose to stop having cervical cancer screening. In addition, women who have had a total hysterectomy – removal of the uterus and cervix – may also choose to stop having cervical cancer screenings, unless the surgery was done as a treatment for cervical cancer or pre-cancer. Women who have had a hysterectomy without removal of the cervix should continue to be screened according to the normal guidelines.
Talk to your doctor about your health history, cervical cancer risks and the HPV vaccines. He or she can help you determine a course of action to reduce your chances of developing cervical cancer. If you have a daughter or female relative or friend between the ages of 10 and 26, encourage her to talk to her doctor about the HPV vaccines for cancer prevention. Remember, reducing your risk factors and detecting cancer early will increase your chances of successful treatment – and survival.
MCG Health, Inc. (d/b/a MCGHealth) is a not-for-profit corporation operating the MCGHealth Medical Center, MCGHealth Children’s Medical Center, the Georgia Radiation Therapy Center, and related outpatient facilities and services throughout the state. For more information, please visit mcghealth.org
Editorial note: Dr. Sharad A. Ghamande is a professor of obstetrics and gynecology at the Medical College of Georgia and Chief of the Section of Gynecologic Oncology at MCGHealth. Dr. Ghamande is included in the fifth edition of “America’s Top Doctors for Cancer®,” a patient reference guide that identifies the nation’s most outstanding cancer physicians. Dr. Ghamande is a top cancer doctor in the category of gynecology/oncology. His clinical and research interests include ovarian cancer, cervix cancer and chemotherapy trials.
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