La Porte Hospital and Dr. Ashley Kirkwood of La Porte Physician Network are focusing on helping women in our community prevent cervical cancer. One of the great success stories in cancer research, since annual Pap test cervical cancer screenings were introduced in the 1950s, cases of what was once the number one cancer in women have plummeted. Human Papillovirus (HPV) vaccination has further reduced the numbers.
Today, we know cervical cancer can be prevented with proper screening to find pre-cancers before they develop into invasive cancer,” said Dr. Ashley Kirkwood, an obstetrician/gynecologist with offices in La Porte and Knox. “Pap smears are designed to detect early cellular changes, called dysplasia, before they progress, allowing us to intervene and treat these early changes in simple, non-invasive ways. Even more exciting is the HPV vaccine, which can prevent the cellular changes from starting at all”
One factor in cervical cancer is the prevalence of the human papilloma virus (HPV) in society. An estimated 80% of sexually active women will become infected with the virus at some point, but of the more than 100 strains of HPV identified, only a few high-risk strains are connected to cervical cancer. The vast majority of HPV infections resolve without any treatment or intervention.
The Centers for Disease Control and Prevention recommends young women and men receive HPV vaccination at 11 or 12 years of age to provide the best protection long before the start of any sexual activity. While the vaccine works best when started at age 11-12, the FDA has approved the HPV vaccine for patients up to 45 years of age.
“Unfortunately, the CDC reports more than 4,000 U.S. women still die from cervical cancer every year,” said Dr. Kirkwood. “Women at risk of dying from the disease today are those who have been screened infrequently – or not at all. This is a tragedy, as the majority of these cases are preventable.”
Recently, changing guidelines about screening frequency have created confusion. What used to be a clear direction from the American Cancer Society – “get a yearly Pap test” – has become less clear. Recommended time between screenings is now longer, and two separate tests are available.
While not all physicians agree on the new guidelines, following are good rules from the American Congress of Obstetricians and Gynecologists and the American Cancer Society to protect yourself against cervical cancer. Be proactive in discussing with your doctor whether these screening guidelines are right for you.
- All women should begin cervical cancer screening via a Pap test at age 21.
- Women between the ages of 21 and 29 should have a Pap test at least every three years. HPV testing should be done only if needed after an abnormal Pap test.
- Women between the ages of 30 and 65 should have both a Pap test and an HPV test at least every five years.
- Women over 65 who have had regular screenings with normal results should not be screened for cervical cancer.
- Women who are at increased risk for cervical cancer may need to increase the frequency of these screenings. Notably, African American and Hispanic women have a higher incidence of cervical cancer than other ethnic groups.
In short, the American Cancer Society no longer recommends getting a Pap test every year, because it generally takes longer than that (10-20 years) for cervical cancer to develop. As the debate continues, there may be a future option to have a test for HPV alone, although this is not the current standard. As always, discuss with your doctor the appropriate screening schedule based on your age, lifestyle and risk factors.