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Cervical Cancer Awareness and the Importance of Routine Screening

January is Cervical Cancer Awareness month and as we start 2024, let this be your gentle reminder to stay up-to-date with your screening and prevention. 


In the United States, about 11,500 new cases of cervical cancer are diagnosed each year, and about 4,000 women die each year from cervical cancer.  Despite these staggering numbers, many people don’t know what constitutes screening for this disease.  The most effective screening method is regular pap smears performed by your gynecologist or family physician.  And while you may have other exams or cultures performed during a pelvic exam, you want to ensure that a pap smear is being collected and send for laboratory testing on a regular basis. 


What is the relationship between HPV and cervical cancer?

One common question is about the connection between the Human Papilloma Virus (HPV) and cervical cancer.  HPV is the virus known to cause cervical cancer.  If you have not been diagnosed with HPV, the changes of spontaneously developing cervical cancer are very low.  Alternatively, having a diagnosis of HPV does not mean that you are guaranteed to develop cervical cancer.  It simply increases the risk.  HPV causes damage to the healthy cells, causing them to divide abnormally and develop into cancer if they cannot repair themselves.  It takes approximately 5 to 10 years for abnormal cells to turn into cancer.  But there are variations of HPV and not all types lead to the development of cervical cancer.  Most women’s bodies are able to get rid of the HPV virus on their own, over time.



What are the risk factors for cervical cancer?

Risk factors for other illnesses can also be risk factors for developing cervical cancer, such as smoking cigarettes, having HIV or a weakened immune system.  One easily modifiable risk factor is to quit smoking if you are a current smoker. 



How often should cervical cancer screening be done?

The clinical guidelines for how often women should be screened for cervical cancer have changed over the years as research has provided additional data.  Currently, it is recommended that women begin getting pap spears after the age of 21, regardless of sexual activity.  After the first pap smear, as long as the results are normal, screening is only necessary every three years up to age 30.  For women who are 30 to 65 years old, co-testing for cervical cancer and HPV is recommended every five years.  With continued normal results this is a safe screening schedule. 


Cervical cancer screening is different from other cancer screening options in that it is effective at catching cellular abnormalities before they develop into cancer.  Other screening methods catch cancer in early stages.      



When can I stop screening for cervical cancer?

Here is the good news!  After the age of 65, if your pap smears have been normal for the prior 10 years, you don’t ever need a pap smear again. 



Do women who have had a hysterectomy need a pap smear? 

It depends on the extent of the hysterectomy and the original reason the hysterectomy was performed.  If the cervix has been removed, a routine pap smear is not necessary, as long as the pap smears leading up to the hysterectomy were normal.  If the hysterectomy was performed as a result of abnormal pap smears to prevent cancer, then ongoing screening will be necessary.  Or, if a hysterectomy was the result of a diagnosis of uterine cancer, the doctor may recommend routine pap smears even in the absence of a cervix.  The safest screening schedule is entirely customizable based on the individual patient and should be something you discuss with your doctor to establish the best plan for you.



Why is cervical cancers screening not recommended before age 21? 

A diagnosis of cervical cancer is very rare prior to the age of 21.  Less than one in one thousand cases of cervical cancer occur in young women between the ages of 15 and 19.  As previously shared, most women in this age range who are diagnosed with HPV are able to rid their bodies of the virus on their own, due to a strong immune system.  Research has shown that there is no advantage to annual screening versus spacing them out over three to five years as is now the practice.


While they do not need pap smears, women under the age of 21 should begin seeing a gynecologist annually after the start of their menstrual period.  The main reason is for general health education and to build a doctor-patient relationship.  Generally, a pelvic exam is not required for women under the age of 21.  It’s important that the gynecologist’s office be a safe space for girls and young women to discuss and learn about their health.



Is cervical cancer screening recommended for non-sexually active women?

The short answer is, yes.  Sexual activity is not limited to intercourse so if there is any sexual activity at all, it is best to get routine testing.   



Is an annual gynecologist visit necessary if annual pap smears aren’t required? 

Yes!  It is very important that you maintain at least annual visits with your gynecologists, despite your pap testing schedule.  Your physician is going to evaluate many other aspects of your health, in addition to your cervical health.  You can experience many changes in your body over the course of a year and it’s important to stay proactive about all aspects of your health including breast health, sexual health, hormonal health, etc. Often, conditions may be present without noticeable symptoms, so it’s important to be open with your doctor about how you’re feeling and any changes that have taken place.  Important topics such as diabetes, diet, exercise, mental health, medications, pregnancy and menopause are all topics that a physician will likely cover.     



What if my pap smear results are abnormal?

Many women have abnormal pap smear results and aren’t diagnosed with cervical cancer.  An abnormal result is an indicator that you need to be followed more closely. Your gynecologist will guide you as to what the options are for monitoring and managing any abnormalities depending on your specific results.    


If indicated, a procedure called a colposcopy may be performed to take biopsies of the cervix and send them for laboratory evaluation.  If there are high-grade abnormalities, a LEEP (Loop Electrosurgical Excision Procedure) to remove targeted tissue using a fine wire loop and electrical current.  Removal of the abnormal cells can stop cancer before it has a chance to form. 




Your health is a priority, and I'm here to support you every step of the way. If you have questions about cancer screening or would like to discuss which options are best for you, don't hesitate to reach out. Schedule a consultation with me, Dr. Jennifer Bliss, at Texas Well Woman in Sunrise Reach, Texas.


Together, we'll create a personalized screening plan tailored to your unique needs and risk factors. Your proactive approach today can make all the difference tomorrow.


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