Tools to combat cancer
No woman should die of cervical cancer. But many do. Women should talk to their physicians about this disease, which claims the lives of more than 4,000 women each year. Some 93 percent of all cervical cancers could be prevented by screening and vaccination for human papillomavirus (HPV). Screenings work. However, in a 2012 survey, eight million women in the United States (10 percent of women ages 21-65) said they had not been screened for cervical cancer in the previous five years. The HPV vaccination helps prevent infection with the types of HPV that result in most cervical cancers. While the Papanicolaou (Pap) test screens for abnormal cells that may become cancerous, the HPV test screens for the HPV virus that causes the changes to the cells. The U.S. Centers for Disease Control and Prevention recommends strongly that preteen and teenage girls get vaccinated against HPV. Many people do not realize that boys can get HPV. The CDC also recommends that boys ages 11-12 be vaccinated. Receiving all doses as recommended before they are exposed to HPV will give them the best protection. Meanwhile, if they have not already been vaccinated, also should do so. (2) In both men and women, papillomavirus can show up in venereal warts which can become cancerous. Papillomavirus can be a sexually transmitted infection and can be caught at any age. Papillomavirus has also been noted as the inciting cause in some anal rectal cancers. HPV is also seen in some penile cancers, head and neck cancers, and oral cancers. (1)
Most infections not pre-cancers
HPV infections can occur in childhood but can lead to cervical cancer in the same person as an adult. While most HPV infections do not turn into pre-cancers, and pre-cancers may still revert to normal, others do result in cervical cancer. More than five American women in 100,000 (0.005%) died of cervical cancer in 1975. The number decreased until 2007, when it flat-lined at slightly fewer than two deaths in 100,000 (0.002%). The CDC believes more reductions can be achieved. But while so many women have not been screened, lack of access is not a factor. That’s because seven out of 10 women who were not screened from 2007-2012 had a regular doctor and health insurance. Doctors, nurses and health systems can improve the numbers. According to the November 2014 edition of CDC Vitalsigns, healthcare workers can help women understand when they should get screened and what screening tests are best for them as individuals. They can screen or refer all women for screenings during regular office visits. They can make sure patients get screen results and plan proper follow-up care quickly, when needed. They should use reminder and recall systems to help physicians, nurses and patients remember when screenings and HPV vaccinations are upcoming. (2)
Consult your physician
The CDC says women ages 21-29 should have Pap tests every three years. During an exam, doctors or nurses collect cells for the test, which can find abnormal cells that – if left untreated – may develop into cancer. Women ages 30-65 should consult their physicians and choose from two options. They either should have Pap tests every three years or have a Pap test plus an HPV test every five years. The HPV test can find the HPV virus by testing cells collected at the same time as the Pap test. Meanwhile, through the Affordable Care Act, the federal government ensures that most health insurance plans cover cervical cancer screenings and HPV vaccinations (for both males and females) at no additional patient cost. The federal government also increases access to immunizations through the Vaccines for Children (VFC) program and funds programs that increase cervical cancer screening rates. (3) For example, more than 4.3 million women who have limited access to health care received breast and cervical cancer screening and diagnostic services in the first 20 years of the CDC’s National Breast and Cervical Cancer Early Detection Program. More than 56,000 breast cancers, 3,000 cervical cancers and 152,000 precancerous cervical lesions were detected from 1991 to 2011. In more than 90 percent of these cases, the women received appropriate and timely follow-up care, the CDC said. (3)
More recommendations from the CDC
– Being tested more frequently than recommended does not ensure more protection.
– One’s health history may play a factor in her screening schedule.
– Women over age 65 should consult their physician as to whether they need to continue screening. All women should make sure they understand their screening results after talking to their physician or nurse.
– Even after being vaccinated, women should begin screenings for cervical cancer at age 21. (2)
References
1. Human Papillomavirus Causes of Cancer – http://www.cdc.gov/hpv/cancer.html
2. CDC Vitalsigns. Cervical cancer is preventable. – http://www.cdc.gov/vitalsigns/pdf/2014-11-vitalsigns.pdf
3. Millions of underserved women in the US have benefited from CDC’s breast and cervical screening program – http://www.cdc.gov /media/releases/2014/p0806-cancer-screening.html