March 15, 2008
Cervical Cancer Screening-
a vital component for Women's Health
The National Cancer Institute reports that each year one out of 142 women will be diagnosed with cervical cancer during their lifetime.
by Danielle Dizon, YKHC Public Relations
Between 1989 and 2003, eight women were diagnosed with cervical cancer in the YK Delta.
"It is the seventh leading cause of cancer among Alaska Native women in the Yukon-Kuskokwim Delta," said Women's Health Director, Luke Vanasse.
Like other types of cancers, it is usually a slow-growing cancer that can be without symptoms for months. The cancer forms in the lining of the cervix, the organ that connects the uterus and vagina.
Death Rates of Cervical Cancer
The rate of women dying from cervical cancer has varied depending on race and ethnicity. African American women are more likely to die of cervical cancer than any other group, followed by Hispanic women.
The Centers for Disease Control & Prevention reported that of the 11,000 women diagnosed with cervical cancer in 2004, 88 were American Indian/Alaska Native and 31 lost their lives.
Early Detection
An annual Pap smear is a woman's most important responsibility in order to screen for abnormal cells in the cervix that can cause cervical cancer. When cervical cancer is detected at its earliest stage, the chances of the cancer developing are lower.
A pap smear or pap test is a procedure in which cells are gently scraped from the cervix and closely examined under a microscope to find out if they are abnormal. It is recommended that women 18 and older should have an annual pap test.
When should you have a pap test?
Women under 18 years of age should arrange to have a Pap test if they have engaged in sexual activity. Women between the ages of 18 and 64 shold have a Pap test and pelvic exam every one to three years. Even women who have gone through menopause need regular Pap tests to detect any abnormalities.
If needed, the following procedures may further be used in the screening process:
Colposcopy: A procedure in which a colposcope (a lighted, magnifying instrument) is used to check the vagina and cervix for abnormal areas. Tissue samples may be taken using a curette (spoon-shaped instrument) and checked under a microscope for signs of disease.
Biopsy: If abnormal cells are found in a Pap smear, the doctor may do a biopsy. A sample of tissue is cut from the cervix and viewed under a microscope by a pathologist to check for signs of cancer. A biopsy that removes only a small amount of tissue is usually done in the doctor's office. A woman may need to go to a hospital for a cervical cone biopsy (removal of a larger, cone-shaped sample of cervical tissue).
Pelvic Exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. The doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and places the other hand over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. A speculum is also inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. A Pap test of the cervix is usually done.
Risk Factors
Infection of the cervix with certain types of human papillomavirus (HPV) is a major risk factor for development of cervical cancer. Women who do not regularly have a pap smear to detect HPV or abnormal cells in the cervix are at increased risk of cervical cancer. Not all women with HPV infection, however, will develop cervical cancer.
The human papillomaviruses are a group of more than 100 viruses. They are called papillomaviruses because certain types may cause warts, or papillomas, which are benign tumors.
Of more than the 100 types of HPV, over 30 types can be passed from one person to another through sexual contact. Most HPV infections occur without any symptoms and go away without any treatment over the course of a few years.
The Gardasil vaccine is a preventive HPV vaccine available for women. It protects against four types of HPV and is given through a series of three injections into muscle tissue over a 6-month period.
Like an immunization, it guards against viral infection. It is proven to be effective only if given before infection with HPV so it is recommended that it be given before an individual is sexually active. The Federal Drug Administration has approved Gardasil for use in females 9-26 years of age.
It is still important for vaccinated and unvaccinated women to continue to undergo annual cervical cancer screening through pap tests.
Red Flags
Possible signs of cervical cancer include vaginal bleeding and pelvic pain. Other conditions may cause the same symptoms. If you are experiencing unusual vaginal bleeding or discharge, pelvic pain, or pain during sexual intercourse, you should make an appointment with your provider.
All treatment depends on the stage of the cancer, size of the tumor, desire to have children, and their age.
YKHC's Women's Breast and Cervical Cancer Early Detection Program
The Women's Breast and Cervical Cancer Early Detection Program is a grant from the Center for Disease Control & Prevention. The purpose of the grant is to enable women to have paps, clinical breast exams, and mammograms.
The program helps eligible women pay for procedures. If you are unable to pay for yourself, if your insurance does not cover the full bill, the Women's Health Grant will help you.
Travel assistance is also available for eligible participants. If you live in a village and cannot afford to fly in, if you live in Bethel and need to get to Anchorage for a procedure not offered here but do not have the funds to buy the tickets, the Women's Health Grant will help you.
If you have not had a pap test in the last year, make an appointment today or call Women's Health to learn how you can enroll in the program.
For more information:
YKHC's Women's Health Program: www.ykhc.org/womenshealth
Cervical Cancer Statistics: www.cdc.gov/cancer/cervical/statistics/race.htm
Cervical Cancer Facts: www.cancer.gov/cancertopics/types/cervical
HPV Vaccine: www.cancer.gov/cancertopics/hpv-vaccines