Cervical Health Awareness Month—OSMA Experts Share Insights
January is Cervical Health Awareness month, so we asked three OSMA member and experts on women’s health to share their insights on the importance of vaccination, regular screenings and other methods of prevention and care. Featured in this Q&A are Dr. Anthony Armstrong, an OBGYN practicing in Toledo, and Dr. Lisa Egbert, an OBGYN practicing in Dayton – both past presidents of OSMA, as well as Dr. Mary LaPlante, an OBGYN who practices in Cleveland and serves on the AMA Council on Science and Public Health.
What is cervical cancer? How prevalent is it?
Cervical cancer occurs when cervical cells become abnormal and, over time, grow out of control. The cancer cells invade deeper into the cervical tissue. In advanced cases, cancer cells can spread to other organs of the body. Each year, there are 12,000 cases of cervical cancer leading to over 4,000 deaths in women. Worth noting, each year, there are also 9,300 cases of HPV-related cancers in men. (Dr. Armstrong)
Are there ways to help prevent cervical cancer?
I wish patients knew how effective HPV vaccination is in protecting against cervical cancer, especially if completed as recommended, prior to the initiation of sexual activity in the preteen age group. In addition, vaccination is now recommended up to 45 years of age, so those who didn't receive it as children or teenagers are now eligible and should ask their doctor about it. (Dr. Egbert)
It usually takes 3 to 7 years for high-grade changes in cervical cells to become cancer. Cervical cancer screening may detect these changes before they become cancer. Women with low-grade changes can be tested more frequently to see if their cells go back to normal. Women with high-grade changes can get treatment to have the cells removed. The bottom line is, cervical cancer screening saves lives. Over the past 30 years in the United States, cervical cancer cases and deaths have decreased by one half. This is mainly the result of women getting regular cervical cancer screening. Additionally, The HPV vaccine is highly effective when given before a person has sex.
When a woman is getting proper screening, changes will be detected and can be treated before cancer ever develops. However, if you have a normal Pap test or negative HPV test, it does not mean you do not have HPV—it can be sitting silent and cause changes later in your life even if you do not have a new partner for intercourse. Once you have a positive HPV test, it does not mean it will always be positive, but it does mean you need to make sure you follow up as recommended by your physician. (Dr. LaPlante)
What are symptoms to watch for related to cervical cancer? When should patients see their physician outside of regular screenings?
HPV is very common—most people who are sexually active will get an HPV infection in their lifetime. HPV infection often causes no symptoms. Most people do not even know they are infected. That’s why regular screenings and the HPV vaccine are so important. (Dr. Armstrong)
I would stress the importance of continuing annual check-ups, even if a pap is not due. I would also encourage patients to report to their doctors if they have had new sexual partners so that screening could be completed. (Dr. Egbert)
When you are considering becoming sexually active or at 21 years old, you should begin yearly gynecological exams. You should also see your ob-gyn if you have irregular bleeding, bleeding after intercourse or foul-smelling vaginal discharge. (Dr. LaPlante)
What regular screenings are in place to help with early detection?
Cervical cancer screening includes the Pap test, an HPV test, or both. Both tests use cells taken from the cervix, and the screening process is simple and fast. You should start having screening at age 21, regardless of when you first start having sex. How often you should have cervical cancer screening and which tests you should have depend on your age and health history, so check with your doctor. (Dr. Armstrong)