By Kathy Hubbard
Once upon a time cervical cancer was the number one cause of cancer deaths for American women. Now, thanks to the common screening procedure called a Pap test or Pap smear, cervical cancer ranks fourteenth in frequency. Last year, 13,240 new cases were estimated to be diagnosed with just over 4,000 women dying from the disease, roughly 60 percent fewer than in the 1950s.
“Cervical cancer is a type of cancer that occurs in the cells of the cervix – the lower part of the uterus that connects to the vagina,” explains Mayo Clinic’s website. “It begins when healthy cells acquire a genetic change (mutation) that causes them to turn into abnormal cells.
“Healthy cells grow and multiply at a set rate, eventually dying at a set time. Cancer cells grow and multiply out of control, and they don’t die. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can break off from a tumor to spread (metastasize) elsewhere in the body.”
The Pap test can reveal changes in the cervical cells that may turn into cancer at a later date. It’s performed either by your primary care provider or a gynecologist. During the pelvic exam, the medico will insert a speculum into your vagina in order to be able to see your cervix. Then using a swab, sample cells are removed, placed in a solution and sent off to the lab.
It isn’t the most lady-like procedure – you’re legs are up in the air, your feet are in stirrups – but it doesn’t hurt. All you might feel is a little pinch or a bit of pressure.
So, what causes cervical cancer? “It isn’t clear what causes cervical cancer, but it’s certain that human papilloma virus (HPV) plays a role. HPV is very common, and most women with the virus never develop cervical cancer. This means other factors — such as your environment or your lifestyle choices — also determine whether you’ll develop cervical cancer,” Mayo says.
Most cervical cancers are squamous cell carcinomas. These are flat cells that line the outer part of the cervix which projects into the vagina. Adenocarcinoma is the type of cervical cancer that begins in the column-shaped glandular cells that line the cervical canal.
Risk factors include having many sexual partners particularly if they themselves have many sexual partners; starting to be sexually active at a young age which increases risk of HPV; having other sexually transmitted diseases such as chlamydia, gonorrhea, syphilis and HIV/AIDS; a weak immune system, and smoking. (Honestly. Smoking. I didn’t make that up to get you to quit! Look it up.)
“Early-stage cervical cancer generally produces no signs or symptoms. More-advanced cervical cancer signs and symptoms include vaginal bleeding after intercourse, between periods or after menopause; watery, bloody vaginal discharge that may be heavy and have a foul odor; pelvic pain or pain during intercourse,” Mayo says.
In 2006 the Food and Drug Administration licensed the first HPV vaccine. It’s important to note that HPV can cause other conditions such as genital warts and vaginal, vulvar, anal, penile and oropharyngeal (throat and tongue) cancers as well as cervical cancer. But we’re not talking about those diseases today.
The Centers for Disease Control’s recommendation is that pre-teens, both girls and boys, receive the HPV vaccine when they’re 11 or 12 years old. It’s most effective when administered to preteens but it can be administered up to age 26 although the American Cancer Society website says it’s not as effective for those over 21. It’s safe and has few potential side effects, but, I whole-heartedly recommend you talk to your child’s pediatrician to discuss the pros and cons as some parents have ethical questions regarding the proper age to discuss sexual activities.
Between the ages of 21 and 29, it’s recommended that you should get a Pap test every three years. Between 30 and 64 you should get the Pap and HPV tests every five years, if you’re over 65 and haven’t had cervical cancer you can stop.
My best advice is not to pay any attention to these suggestions, but to talk to your PCP instead. If you don’t have a PCP, give Sandpoint Women’s Health a call at 208-263-2173 to set up an appointment.
Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at firstname.lastname@example.org.