January is National Cervical Health Awareness Month. This promotion is important because more than 4,000 women die in the United States each year from cervical cancer and women who don’t have screening on a regular basis significantly increase their chances of developing the disease.
In many developing countries, cervical cancer is the No. 1 killer of women. Even in the United States, 11 percent of women report they do not have regular cervical cancer screenings.
Promoters of National Cervical Health Awareness Month want to stress the importance of preventive screenings for women. Pap tests and pelvic exams should be important parts of a woman’s routine health care because these can detect cancer or abnormalities that may lead to cervical cancer.
Women should have a pap test at least once every three years, beginning around age 21 or about three years after they become sexually active (if this is before age 21). About 55 million pap tests are performed each year in the United States. Of these, only about 3.5 million (6 percent) are abnormal and require medical follow ups. This does not necessarily mean, however, that cancer is present in each of these cases. It just means that further tests may be necessary to make sure. Cervical cancer is extremely rare in women under age 25.
Simple, quick and painless, a pap test (or smear) can be done in a doctor’s office or a clinic. The test is a way to examine cells collected from the lower, narrow end of the uterus or cervix. The main purpose of the test is to find abnormal cell changes that may arise from cervical cancer or before cancer develops. Most invasive cancers of the cervix can be prevented if women have pap tests regularly. Even if cancer is detected, it is more likely to be treated successfully if it is detected early.
It is also important to understand that abnormal conditions do not always become cancerous, but some conditions are more likely to lead to cancer than others. The only way a woman can know what is happening to her body is through regular screenings such as pap tests.
Human papillomavirus infection is the primary risk factor for cervical cancer. A group of more than 100 viruses, HPVs include types that cause common warts found on hands and feet and some that are sexually transmitted and that cause wart-like growths on the genitals. While these types do not lead to cancer, we know that more than a dozen other sexually transmitted HPVs have been linked to cervical cancer.
HPV infection is more common in younger age groups, particularly among women in their late teens and 20s. HPVs are spread mainly through sexual contact with the following factors increasing the risk of acquiring the disease:
• Women who become sexually active at a young age
• Women who have multiple sexual partners
• Women whose sexual partners have other partners
Women who are infected with the human immunodeficiency virus are also at higher risk for being infected with HPVs and for developing cervical abnormalities. Nonsexual transmission of HPVs is rare. Evidence of the virus often disappears but sometimes remains detectable in the body for years after infection. The new human papillomavirus vaccine is recommended in a three-dose schedule for females ages 11-12 years. The vaccination series can be started in females as young as age 9, and a catch-up vaccination is recommended for females aged 13-26 years who have not been vaccinated previously or who have not completed the full vaccine series.
Women should plan to have their pap tests when they’re not menstruating; the best time is between 10 and 20 days after the first day of the last menstrual period. For about two days before a pap test, women should avoid douching or using vaginal medicines or spermicidal foams, creams or jellies (except as directed by a physician) because these can wash away or hide abnormal cells.
Women ages 65 to 70 who have had at least three normal pap tests and no abnormal pap tests in the last 10 years may decide, after talking with a health-care provider, to stop having pap tests. Women who have had surgery to remove the uterus and cervix do not need to have pap tests unless the surgery was done as a treatment for pre-cancer or cancer. Younger women who have not already done so should schedule their cervical screenings this month. Husbands also must encourage their wives to get cervical cancer screenings.

Ratcliffe is a consultant with the Georgia Coastal Public Health District. You can call her at 876-6399.