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January is National Cervical Health Awareness Month

Cervical cancer is now largely preventable

Karen Miller | 1/23/2014, 11:53 a.m.

As recently as the 1940s, cervical cancer was a major cause of death among women in this country. That changed when Dr. George Papanicolaou developed the Pap smear, or Pap test, that enables doctors to detect suspicious cells in the cervix (lower end of the uterus) before they became cancerous. It can also diagnose cancer at an early stage when treatment is more successful. With regular screenings and follow-up cervical cancer is highly preventable.

The development of the Pap smear had a significant impact. According to a report by the National Institutes of Health, between 1955 and 1991, the incidence and death rates attributed to cervical cancer declined by more than 60 percent, making it now the 14th most common cancer in women. The American Cancer Society (ACS) estimates that 12,340 women were diagnosed with cervical cancer in 2013 and 4,030 succumbed to the disease.

The Pap smear tests for cervical cancer only and does not screen for cancers of the uterus and other parts of the female reproductive system.

During the test the provider takes samples of the cells of the cervix using a soft brush or a flat scraping device. The samples are viewed under a microscope for suspicious changes. A positive result, which means that abnormal or unusual cells were discovered, does not necessarily indicate cancer. Several infections can cause temporary changes. However, if the abnormalities persist over a period of time, additional testing is required.

While Pap smears detect cancerous and pre-cancerous cells, vaccines can prevent the human papillomavirus, or HPV, which is the cause of virtually all cases of cervical cancer. HPV vaccines are administered in a three-shot series over a period of six months. They are recommended for girls as young as nine, but may be given up to the age of 26.

Cervical cancer is more common in Latinas and blacks, but black women die of it at a greater rate than any other race. It is more prevalent in middle age. According to the National Cancer Institute, more than 36 percent of the cases are found in women over the age of 55.

In addition to infections of HPV, other risk factors for cervical cancer are smoking and diseases that suppress the immune system, such as HIV, the virus that causes AIDS.

Below are general guidelines for cervical cancer screening. A test for HPV is now recommended in conjunction with the Pap smear for women of a certain age. Your doctor may recommend a different schedule for you. The American Congress of Obstetricians and Gynecologists and the ACS recommend the schedule below.

Women who have been immunized against HPV should continue screening. Vaccination protects against HPV 16 and 18, which are the leading cause of cervical cancer. However, other types of HPV infections cause cervical cancer as well.

For an interactive tutorial on Pap smears, visit MedlinePlus at http://www.nlm.nih.gov/medlineplus/tutorials/papsmear/htm/index.htm.

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Cervical cancer screening

Age 21Begin Pap smears regardless of prior sexual history
Ages 21 to 29Repeat Pap smears every 3 years
Ages 30 to 65Repeat Pap smears combined with HPV testing every 5 years or continue Pap smears alone every 3 years
Age 66 and olderDiscontinue screening in women who have had adequate screenings and normal results
After hysterectomyRecommend against screening in women of any age who have had a hysterectomy with removal of the cervix