Testing It Up

Cervical cancer is the third most common form of cancer worldwide, and more than seventy percent of cases can be attributed to the human papillomavirus (HPV). What are you doing to protect yourself against cervical cancer?

One of the known ways through which one can prevent the onset of cervical cancer is through vaccination. Dr. Vivien Brown, branch president for the Toronto Federation of Medical Women of Canada and prominent advocate of the prevention and screening of cervical cancer, said: “What is so exciting about human papillomavirus [HPV] vaccine is that we now have an understanding of the link between a virus, an infection, and the cause of a cancer.”

Dr. Brown shared further: “By vaccinating, we are not simply preventing infection, as we do with measles, for example, we are preventing an actual cancer. So the aim in women and men is not only to pick up disease early when it is still treatable, but to prevent it entirely, to block inception.”

If one does get diagnosed with cervical cancer, the prognosis is usually promising for as long as it is detected early. Cases of cervical cancer saw a dramatic decline after the simple test called Papanicolau smear, or “Pap smear,” was introduced.

Pap tests are recommended for women upon reaching the age of 21, regardless of whether she has engaged in penetrative intercourse or not. If one becomes sexually active before the age of 21, it is recommended that one should begin Pap smears three years after the start of intercourse.

There are several health conditions that women need to watch out for, and one of these is cervical cancer.

In the United States, more than 12 thousand cases of cervical cancer are diagnosed each year. It is encouraging to note, however, that if detected early enough, cervical cancer is a disease that is highly curable, and therefore, survivable.

Cervical cancer is characterized by the development and spread of abnormal cells in the cervix, a condition that is usually triggered by the human papillomavirus (HPV).

The initial onset of the disease is rarely accompanied by recognizable signs, but as it progresses, a patient may experience any of the following symptoms: unusual vaginal discharge, vaginal bleeding between periods, bleeding after menopause, and bleeding or pain during intercourse.

HPV is a common virus, and most people who have been sexually active at some point in their lives are at risk for getting the virus. HPV, however, may linger in the body quietly, and it is possible to carry the infection for years.

Aside from cervical cancer, HPV is also associated with cancers of the vulva, vagina, and penis, as well as anal and oral cancers.

Any high-risk HPV strain that may linger in the body may trigger the development of abnormal cells in the cervix. While these precancerous growths do not necessarily mean that one has cervical cancer, it is possible that these abnormal growths may eventually give way to cancer cells.

As mentioned earlier, early detection is key to surviving cervical cancer, and this is achievable by undergoing regular Pap tests. It is recommended that women start having Pap tests three years after becoming sexually active, and no later than age 21. In addition to a Pap test, doctors may also recommend an HPV DNA test, which checks for the presence of high-risk forms of HPV.

The saying two heads are better than one may also apply to cervical cancer testing, after a study determined that while Pap smears will be able to detect the disease, a combination of a Pap test and a test to detect the human papillomavirus (HPV) is able to provide a more accurate diagnosis.

The results of the study was published online in The Lancet Oncology.

Study author Philip Castle, a researcher at the American Society for Clinical Pathology Institute in Washington, D.C., shared further that for women who were found to be positive for HPV, there was no need for a Pap test: “We could have used the HPV alone and gotten the same results.”

The study, which was funded by HPV test manufacturer Roche Molecular Systems, looked into a DNA-based HPV test manufactured by Roche. It consisted of evaluating the test results for almost 41,000 women, aged 25 and older, who were enrolled in 61 studies in 23 states. The researchers took two samples for each participant, for Pap tests and HPV tests. Women whose Pap tests revealed abnormal cells, or who may have normal Pap results but were positive for HPV, were referred for a colposcopy.

Ten percent of the study participants tested positive for HPV, while 6 percent had abnormal Paps. Of this number, 705 were found to have pre-cancerous lesions.

Among the participants who underwent colposcopy, it was determined that the HPV is able to detect higher-grade lesions better, over Pap tests. Dr. Elizabeth Poyner, a gynecologic oncologist and pelvic surgeon at Lenox Hill Hospital in New York City, gave the following statement: “This study has demonstrated that it may be possible to replace the Pap smear with a more effective screening strategy employing the use of high risk HPV testing alone.”

New York Health Screening

Pap smears have been viewed for about half a century as an effective and inexpensive way to detect cervical cancer early. Beating cervical cancer, as in other types of cancer, often depends on early detection of cancer.

Pap smears are usually performed once a year, and is usually part of a woman’s annual wellness or gynecological exam. Doctor’s groups, however, have since issued recommendations regarding the frequency of Pap smear, increasing the time between tests.

The recommendations governing pap smears, as issued by the American Congress of Obstetricians and Gynecologists (ACOG) and the American Cancer Society, are as follows:

- Women who are not yet 30 should get Pap smears once every 2 years.
- Women aged 30 years and older should get Pap smears every two years. After three successive normal Pap test results, women in this age group may lengthen the interval between tests to once every 3 years,  provided that:
— she does not have a history of moderate or severe dysplasia
— she is not infected with human immunodeficiency virus (HIV)
— her immune system is not weakened
— she was not exposed to diethylstilbestrol (DES) before birth

A study conducted by researchers from the Centers for Disease Control and Prevention, and published in the Journal of Obstetrics and Gynecology, found that most doctors prefer to stick by age old cancer strategies, as opposed to heeding the recommendations of experts. The study found that around 70 percent  of doctors still recommend that women undergo annual pap smears.