Declining death rate

Once the leading cancer in women, cervical cancer has dropped to 14th place in terms of cancer frequency. About 12,000 new cases of cervical cancer occur annually, and about 4,000 result in death.   Worldwide, 275,000 deaths occur from cervical cancer. This can be prevented.

In the 1940s, cervical cancer was a leading cause of death amongst women. However in the 1950s, the Papanicolau smear, a slide containing cervical mucus and skin cells, allowed microscopic examination to find pre-cancers and early cancerous changes. This reduced women’s risk of contracting serious undetected cancer requiring surgery and advanced cancer treatment.  

The death rate began to decline.

From 1955 to 1992, according to the National Cancer institute, the  rate of cervical cancer and death declined by 60 percent.

A small annual test saved thousands of women.

The last 20 years have been good news for women regarding cervical cancer. Further advances in research determined that cervical cancer was almost always caused by HPV, the human papilloma virus.

In fact, further research showed that of the 150 different types of HPV, only a handful were associated with high risk skin changes.   

If cancer on the cervix is undetected and untreated it can grow deep into a woman’s uterus, damaging her ability to bear children, and endangering her life.

Improved chances

Two scientific technologies improved women’s chance of escaping dangerous cervical cancer.

First, a new  type of cervical cancer test. It is a liquid based collection of the traditional Pap smear. The liquid allows better imaging of skin cells for precancerous changes, and the liquid can be tested for high risk HPV DNA. This is a major advance in women’s health.

New technologies such as the ability to test the DNA of HPV for high risk types, allow health care providers to find the earliest possible changes. By finding and treating problems before they become life altering or life threatening, women’s health became better.

Better testing was rapidly followed by the production of vaccines which immunize women against high risk HPV.

While many women will develop their own immunity against HPV, at least 10 percent of women are unable to do this. Therefore, vaccinations protect girls and women, and also boys.

An estimated 6.2 million persons in the United States are newly infected each year, making this the most commons sexually transmitted infection. People who smoke are at higher risk for the HPV and the cancers associated with infection.

The HPV viruses are also causing oral, throat, head and neck cancers for both men and women. So vaccinating early gives children greater protection throughout the life span. The vaccines also protect against anal, rectal, and vulvar cancers. The Gardasil vaccination, in addition, prevents genital warts.

Vaccinations help

Vaccinations are started at ages 11 or 12, because younger children will be in the correct developmental stage to build a strong immune system. By boosting their immune abilities, they are getting protection against future cancers. In particular, protecting children before sexual activity is critical.

It also means fewer pap smears for younger women, and less frequent pap smears for older women. A woman may only need a cancer test (pap smear) every 3 to 5 years, although she will still need an annual woman’s exam. Your own provider can best advise you on your personal or family risk factors.

Imagine if we had a vaccine for colon cancer.

Unfortunately, many people are not aware of the safety or effectiveness of the vaccine. Vaccinations have been able to prevent nearly 100 percent of precancerous changes caused by the highest risk HPV, types 16 and 18. While most HPV infections go away spontaneously, at least 10 percent of all people will be vulnerable.

Higher risk

Children are eligible for free vaccinations, however,  the series of three vaccinations are only received by approximately 40 percent of the population. This leaves 60 percent unprotected and at higher risk.

Only one third of girls receive all three vaccinations. Only 5 percent of boys get vaccinated, according to the CDC. Under the Affordable Care Act, so-called “Obama Care,” the vaccinations are a covered benefit.

Cervical cancer can be reliably detected if women attend their annual visits faithfully, and their gynecology provider will check the frequency of testing needed. There are safe, minimally invasive, in office treatments for most cervical cancer.

While some people debate the safety of the vaccinations and worry about negative side effects, a recent large study in Scandinavia found this was not the case. In 300,000 girls studied in Sweden and Denmark, there were no serious side effects. A vaccination is much safer than death.

The Centers for Disease Control, the National Cancer Institute, and the American College of Obstetricians and Gynecologists have more information and fact sheets on their websites.

• Virginia Beck, Women’s Health Care nurse practitioner, is at West Kauai Clinics, in Port Allen, Eleele. West Kauai Clinics is an outpatient department of Kauai Veterans Memorial Hospital.

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