One of the great success stories in the battle against cancer is the dramatic decline in the rate of cervical cancer deaths:

In the last 40 years, it has declined by more than 50%.

That is directly associated with regular use of the Pap test, which screens for abnormal cells in the cervix.

Cervical cancer is a slow growing cancer, so early detection means early treatment and high success rates in prevention. Women in mid-life are most at risk to develop this type of cancer, and most are found in women who have never had a Pap test, or who have not had one recently.

While Tennessee ranks #10 in the country for percentage of women who get screened regularly, nearly 15% still don’t get screened.

WellTuned spoke to Dr. Robert Yates, an OB/GYN and corporate medical director for BlueCross BlueShield of Tennessee in Memphis, to learn more about this strain of cancer and how to prevent it.

Q&A

WellTuned: When should screenings begin and how often they should be done?

Dr. Yates: They should begin at age 21 and continue every three years following normal results. This is a change from years before when the recommendation was to have a yearly Pap test beginning once a woman becomes sexually active.

WT: What do women need to know before getting a Pap smear?

Dr. Yates: The doctor is looking at cells that shed off the cervix, and anything that can cause trauma to the area can affect that reading. It is probably best to abstain from intercourse the night before the test, and avoid douching, tampons or anything that would disrupt the skin of the cervix.

WT: What are some symptoms that indicate cervical cancer?

Dr. Yates: Unexplained bleeding not related to a period, bleeding after intercourse, a foul discharge that does not clear. If any of these are persistent, you should schedule an appointment with a doctor.

WT: If a woman does get an abnormal result from a Pap smear, what are the next steps?

Dr. Yates: An abnormal Pap smear result will come back with a grade: CIN 1, 2 or 3. CIN stands for cervical squamous intraepithelial neoplasia, and the numbers indicate the degree of abnormality.

• CIN1 may be followed up with another Pap smear or colposcopy.
• With CIN2, a colposcopy will be done in the office. The doctor looks at the cervix with a binocular-like device and takes some small biopsies for evaluation.
• CIN3 indicates a strong suspicion of cancer, and the colposcopy and biopsy are done in that case also for further evaluation.

Often, the biopsy shows a very early form of cancer that may take 10 years to develop into cancer. Depending on the results of the biopsy, treatment can range from office procedures to surgery at a hospital. All of these procedures remove abnormal cells, and if they get them all, then the follow up is to get regular Pap smears and colposcopy when needed.

WT: A vaccine is now available that may help fight the virus that leads to cervical cancer. What should women know about it?

Dr. Yates: Cervical cancer is caused by the human papilloma virus (HPV) and most people in the country have the virus — about 80%. It’s best to get the HPV vaccine when you are young because it seems that immature cells are more susceptible to the virus. There is a lot of debate if the vaccine is effective past the teenage years, and so it is not recommended for girls to get it past 26 and boys past 21.

The vaccine is recommended for both girls and boys. Boys who have HPV can spread it to their partners, and can also get penile cancer from it later in life. The current recommendation is for boys and girls to get the vaccine at age 11.

WT: What do women need to understand about getting regular Pap smears?

Dr. Yates: First, it works. It has cut the rate of death by cervical cancer astronomically.

Cervical cancer was the #1 killer of women and it is now way down.

Second, cervical cancer in its advanced stages is a terrible disease. Fortunately, when you get screened and catch it early, it is curable.

For more information on women’s health, click here.

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