Testing for abnormal cervical cells has traditionally been an annual female exam to prevent cervical cancer. Since pap smear tests started being used in the United States, cervical cancer diagnoses have lessened. Since 2004, it has decreased by another two percent.
Pap smears have become more advanced over the past 15 years. In the beginning, pap smear samples were taken with a wooden spatula, put onto a glass slide, a preservative was added and then it was assessed at a laboratory. This method is less than ideal in many ways. The cells can be concealed by mucous or blood. Cells can also dry out, making it difficult to see them clearly. Recently, a liquid medium has been used to keep the cells well preserved, and make the test more accurate.
The detection of the Human Papilloma Virus has also helped to lower the rate of cervical cancer, which is only a recent development. There are several strains of the HPV virus that cause abnormalities in the cervix, there are also many that can cause cancer. Doctors now perform tests for the most threatening strains of HPV, as well as look for abnormal cells on the cervix, in order to be able to catch the cancer early.
The treatment of the HPV infection is the removal of the cervix. This treatment carries the risk of a possible cervical rupture, even though it is a small risk, it still exists. If the woman is pregnant this treatment increases the possibility of a miscarriage or early birth.
HPV infections that are new, generally go away without creating long-term damage, within two to three years. Therefore, attempting to treat a new infection is a rash reaction for young women. Due to the HPV vaccine, cervical cancer in women under the age of 25 is almost non-existent.
It used to be that yearly pap smears were all that was required for preventative health measures. The American Cancer Society, and American College of Obstetrics and Gynecologists have put together a clear set of guidelines to help women to understand their recommendations.
Women who are at a low risk of cancer, or HPV, are those who do not have any history of precancerous sores, HIV infection, have had an organ transplant, or have taken the synthetic estrogen, diethylstilbestrol. Otherwise, it is recommended that women be screened for abnormal cells, or cytology, every three years, starting at age 21. Every three years is all that is necessary to catch cervical cancer or HPV early enough to be treated.
Beginning at the age of 30, women should have a pap smear, and an HPV test every five years, until the age of 65. Also women who have had a hysterectomy, that includes having their cervix removed do not need to have any more pap smears after three consecutive clean test results. Women over the age of 65 are less likely to get a cancerous HPV strain.
Over screening can cause false positives that will lead to more unnecessary testing. As well as more uncomfortable examinations, bleeding, and pain. It can also lead to cervical biopsies, all of which, are not needed, if the woman is not high risk for cervical cancer.
Annual screenings are a United States tradition, but it is also over screening. Women need to be better informed, concerning the harm of over screening. Some women feel that having screenings less often is a way for insurance companies to save money. In actuality it balances the harms and benefits of screenings and their timings. It is highly recommended that women break the yearly traditional pap smears and follow these recommendations to prevent or stop cervical cancer.
By Jeanette Smith
The Globe and Mail
The Cross Timbers Gazette
Photo courtesy of Pan American Health Organization – Creativecommons Flickr License