About 80 percent of women and girls will become infected with the Human Papilloma Virus (HPV) by the age of 50, making it the most common sexually transmitted disease worldwide.
For most women this infection is transient, which means that their immune systems can get rid of the virus. The concern is for women who have the persistence of HPV, as this can lead to cervical cancer.
Smokers are less likely to get rid of the virus and are therefore at higher risk for getting cervical cancer — just one more reason to quit smoking.
Most women have no symptoms, while some women have genital warts and others have changes on their PAP smear.
A PAP smear is a screen test that looks for pre-cancerous changes and cancer of the cervix. The test was developed by and named after a Greek physician Dr. George Papanicolaou (1883-1962) in the 1920s. Interestingly, his wife Mary was his first and long-term, human subject.
Having regular PAP smears can almost always prevent cervical cancer, but unfortunately no lab test is 100-percent accurate. The recommendations for how often a woman needs a PAP smear have changed recently, and this has lead to some confusion and questions from my patients.
The following recommendations from the American Congress of Obstetricians and Gynecologists (ACOG), the American Cancer Society and the American Society of Colposcopy and Cervical Pathology (ASCCP) are based on evidence.
How often should you have a PAP smear if everything is normal?
Age 21 — First PAP. Women younger than 21 should not be screened regardless of their sexual history
Age 21 to 29 — PAP every three years
Age 30 to 64 — PAP every three years or PAP combined with HPV testing every five years
Age 65 or older depends on your risk factors
After a hysterectomy for benign disease women do not need a PAP.
You need more frequent PAPs if:
You have a history of abnormal PAPs
You have a history of cervical cancer or cancer of the uterus
Your immune system is weakened by chemotherapy or medications given to women after an organ transplant
You are HIV positive
If your doctor recommends a PAP every three years, this does not mean that your doctor visits are every three years. A PAP is only one part of your annual health care visit.
I know you are hoping to hear: “Your PAP was normal and see you at your routine appointment.” If you hear something else, do not panic. An abnormal PAP does not usually mean you have cervical cancer. It is only a screening test and the results must be confirmed by further testing. Your doctor may recommend a test called a colposcopy, which means looking at your cervix with a microscope and possibly taking a biopsy (removal of a small piece of tissue).
Cervical cancer kills almost 300,000 women worldwide every year, even though with early detection it is almost completely preventable. That”s more than 800 women every day. This happens in countries where women have no access to screening and should never happen in this country.
What can you do to prevent cervical cancer?
Go for regular exams and PAP smears as recommended by your doctor and encourage every woman you know to do the same
Limit your number of sexual partners
Use condoms to reduce your risk of HPV infection
Get the HPV vaccine, which is recommended for girls and women aged 9 through 26 years
This column is no substitute for seeing your own health care provider. You can read about all my other escapades on my blog www.drpauladhanda.com/.
Dr. Paula Dhanda is a practicing physician in Kelseyville. She is the founder of Worldwide Healing Hands. She may be reached at 279-8733 or visit http://drspecialtycare.com/ or http://www.worldwidehealinghands.org/.
