The Voice of Southwest Louisiana April 2018 Issue

SWLA Health Center
SWLA Center for Health Services
Pap Testing can
Prevent Cancer
By Dr. John Colligan, MD, Dir. of OB/GYN
The Papanicolaou (Pap) test
was introduced by Dr. George
Papanicolaou in the 1940’s as a
screening test to detect abnormal changes
in the cells of the cervix that can lead to
cervical cancer. Today, Pap testing has led
to a 70% reduction in cervical cancer deaths
in America. Cervical cancer was the number
one cause of cancer deaths for women, but is
now ranked 12th in cancer deaths for women
in the US. This dramatic improvement has
resulted from widespread Pap test screening
programs. Routine Pap testing reduces
both the number of new cervical cancers
diagnosed each year and deaths from the
disease. Pap testing is an essential part of a
woman’s routine health care. Every woman
ages 21 - 65 should receive a Pap test.
Every year, between 250,000 to 1 million
women in the United States are diagnosed
with cervical dysplasia, which is the
medical term for pre-cancer growths on
the cervix. While it can occur at any age, it
most commonly occurs in women between
the ages of 25 to 35. Most dysplasia cases
can be cured with proper treatment and
follow-up. This is due to a long pre-cancer
stage during which conservative treatments
are highly successful in removing pre-cancer
growths before they become cancer. Without
treatment, 30 to 50 percent may progress to
invasive cancer.
Invasive cervical cancer tends to occur in
midlife and is most frequently diagnosed
in women between the ages of 35 and 44.
It rarely develops in women younger than
20. Many older women do not realize that
the risk of developing cervical cancer is still
present as they age. More than 15% of cases
of cervical cancer are found in women over
65. However, these cancers rarely occur in
women who have been getting regular Pap
tests to screen for cervical cancer before they
were 65.
There are general guidelines that
recommend who should receive Pap
testing. Pap testing usually begins
around age 21 and continues until
age 65. Most women do not need Pap
testing after a hysterectomy. There are
certain circumstances when Pap testing
is recommended earlier than age 21, after
age 65, and in women who have had a
hysterectomy. Frequency of Pap testing is
usually every three years if previous tests
were negative.
In the United States, Hispanic women are
most likely to get cervical cancer, followed
by African-Americans, Asians and Pacific
Islanders, and then whites. American Indians
and Alaskan natives have the lowest risk of
cervical cancer in this country.
While there has been a large reduction in
cervical cancer cases and deaths, a serious
problem still exists, especially among certain
populations of women. Unscreened and
under-screened populations of women in
the U.S. historically include older women,
uninsured women, migrant and minority
women, and those residing in rural areas.
The incidence of Pap testing in these groups
has remained inadequate for decades. Since
most invasive cervical cancers are found in
women who have not been routinely tested,
outreach and educational components of
Pap screening programs should include extra
efforts to reach these groups of women who
will benefit most from Pap testing.
Factors that cause Pap test screening to be
successful are, ease of performing the test,
low or no cost to patients, and effectiveness
of the test in identifying pre-cancer cells.
Dr. John Colligan, MD, Dir. of OB/GYN
Resistance to Pap testing is usually due to
a negative emotional disposition to Pap
testing indicating dislike, embarrassment,
discomfort, or anxiety about having the
test. Some have a feeling they are not at risk
since previous Pap tests were negative, or
that nothing is wrong since they have no
symptoms.
Financial barriers are not now a major
concern since Pap testing is available at
low or no cost to most women. Women
must be educated on the need for continued
testing and realize that the discomforts
of testing are very small compared to the
discomforts of cervical cancer. Women
can contact their healthcare provider for
information concerning their individual
needs for Pap testing.
Another method of preventing cervical
cancer, in addition to removing pre-cancer
growths before they develop into cancer, is
vaccination against the Human Papilloma
Virus (HPV), the most common sexually
transmitted infection. Certain strains of HPV
cause cancer, other strains cause genital
warts. While pre-cancer and cancer growths
caused by HPV are uncommon in males, they
do occur on and around the male genital
organs and can also occur in other parts of
the body.
Nearly all sexually active men and women
get an HPV infection at some point in
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April 2018 WWW.THEVOICEOFSOUTHWESTLA.COM Volume 5 • Number 9