Archive for cervical cancer
The identification of the HPV virus has been revolutionary for hopes of developing treatments for prevention of cervical cancer and genital warts. Little did we know years ago that genital warts and cervical cancer were linked.
The HPV virus includes many strains, and 4 strains in particular have been found to cause both of these conditions. A vaccine has been developed for protection against these strains of HPV, and it remains to be seen if we see a significant reduction in the occurrence of cervical cancer and genital warts.
One condition caused by HPV is on the rise however, and is poised to cause significant problems. That is throat cancer. You may have thought this was a cancer of tobacco users only, but sadly that is not correct.
While throat cancer from tobacco is on the decline, throat cancer from HPV is on the rise. In an era where it is felt that the majority of sexually active people are already infected with the HPV virus, the chance of being exposed to HPV through oral sex is assumed to occur. Research has shown that up to 7% of adults have oral HPV.
This is not to say that you definitely will get this virus, or that your immune system will not be strong enough to keep it suppressed. It is very important however, that you have an honest and open discussion with any potential new sex partner about STDs.
In addition to a strengthened immune system, not smoking and utilizing good oral hygiene are ways to decrease your susceptibility to the HPV virus. The only prevention is complete avoidance of sexual contact, however monogamous relationships with a healthy and non infected partner is the next best option.
It is important to understand that most HPV infections are cleared by the immune system, up to 90% are cleared within 2 years from the genital and anal area; researchers are determining how long for throat HPV. While very few oral HPV infections result in cancer, the majority of throat and tonsil cancers are from HPV.
What can you do if you think you may be at risk or an oral HPV infection? Check yourself regularly for any changes within your mouth, tonsils, and tongue. See your provider or see a specialist for changes, painful chewing or swallowing, or evidence of bleeding.
There is no screening test for oral HPV at this time, however research is under way to determine more about detection and prevention. For more information on a study under way, go to the following websites:
I hear this all the time in the clinic, patients will ask me if they still need to get PAP smears now that they have gone through
Yes! It is extremely important to continue to monitor for cervical cancer, although maybe not as often as younger years.
What is one of the risk factors for any sort of cancer?
Age. As we get older, the negative forces on our bodies will wear our body systems down and eventually the immune system may not be able to suppress the causes of cancer.
In relation to the cervix, the most important cause is the HPV virus.
The HPV virus is felt to be the main cause of cervical cancer as certain strains cause inflammation and cellular damage, which can result in cellular atypia (a type of inflammation). Cellular atypia can then progress to cancer. Not all women who have the HPV virus get cervical cancer, and not all women are aware they have ever been exposed to HPV. The HPV virus is transmitted through sexual intercourse and can remain dormant for many years, even decades. So unless a couple has only had sexual relations with each other, exposure can happen unknowingly from past partners.
So why does this matter during menopause? Menopause is considered a period of time during which the immune system is compromised. This can allow a dormant HPV virus to become active and cause inflammation and irritation. And this is the guiding reason for continuing PAP smears after menopause.
The American College of Gynecologists (ACOG) has put forth guidelines for frequency of PAP smears. Women over 30 who have had 3 normal PAP smears in a row can decrease frequency of screening to every 3 years. Many specialists feel that one of these normal readings should include a negative HPV test. And, if your sexual partner changes, you may need to resume yearly PAP smears for a while. Certain risk factors would dictate continuing with yearly PAP’s. These would include HIV infection, other causes of immuno-compromise (anything that decreases immunity like chemotherapy), exposure to DES in utero( DES is a hormone given to pregnant women in the past), prior treatment for CIN2 or CIN3. CIN stands for cervical intraepethelial neoplasia – (inflammatory changes in the cells of the cervix as seen on pap smear – some are pre-cancerous and some are early cancer).
When Can I Stop PAP Smears?
As recommended by ACOG, women can stop screening at age 65-70 if they have had 3 or more normal PAP and no abnormal test in past 10 years. HPV vaccinated women are encouraged to follow these same guidelines.
Cervical cancer rates have fallen by 50% in the last 30 years thanks to vigilant screening . Don’t treat this easy screening test casually, or think it is not important - continue with your screening!
What questions do you have? I can’t tell you what to do but I can help you understand this information better so you can communicate with your doctor more clearly. Leave me a comment. Let me know what you think. And do sign up for the content I have prepared as part of your free membership.
Bruce and I discuss the new cervical cancer screening guidelines. In this discussion we will explain the organization – USPSTF – that issues guidelines and discuss the mission it receives from the Department of Health and Human Services. We review the new guidelines, interject our own non-academic opinions, and give you plenty of information to discuss with your health care provider.
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