Guest Column in The (Monroe, La.) News-Star
Origianally Published January 28, 2010
by Michael Cockerham, Professor and Assistant Dean, ULM College of Pharmacy
Helping to prevent cervical cancer
The American Cancer Society estimated that in 2009 more than 11,000 women were diagnosed with cervical cancer and more than 4,000 women died from the disease in the United States. As most cases of cervical cancer are preventable, January has been designated National Cervical Cancer Awareness Month.
Cervical cancer begins in the lining of the cervix which is the lower part of the uterus or womb. It is a slow-growing cancer that begins when normal cells change to pre-cancer cells and then eventually to cancer cells. This can take many years but can happen faster in some cases.
Cervical cancer most often occurs in women between the ages of 20 and 50 with most occurring in mid-life. Early cervical pre-cancers often do not have any signs or symptoms and therefore regular screening is important.
There are several risk factors for cervical cancer. A risk factor is anything that may increase a person's chance of getting the disease. One of the greatest risk factors is infection with the human papilloma virus (HPV).
Seven out of 10 cervical cancers come from HPV infected patients. Other risk factors include smoking, sexual contact at an early age, multiple sexual partners, many pregnancies, a diet low in fiber and a family history of cervical cancer.
Because cervical cancer can be a preventable cancer, there is an emphasis on prevention by eliminating as many risk factors as possible. Also involved in preventing cancer-related deaths is early screening to detect the cancer in early stages where it can be potentially cured. A decrease in deaths has been seen because of effective screening programs.
One of the most effective ways to prevent cervical cancer is by finding pre-cancers before they turn into cancer. The PAP test or PAP smear is the most common way to do this. The PAP test is performed by looking at the cells on the lining of the cervix to determine if any pre-cancer cells are present.
The American Cancer Society recommends that all women should begin cervical cancer testing every year about three years after they start having sex or no later than age 21.
Starting at age 30, if a woman has no risk factors and three normal PAP tests in a row, then screening can decrease to every two to three years with a regular PAP or decrease to once every three years and include a regular PAP plus the HPV-DNA test. A woman should be screened annually for life if she has a personal history of cervical cancer and/or HIV disease.
Women who have had their uterus and cervix removed may choose to stop having cervical cancer testing unless they were removed to treat cervical cancer. Women 70 years of age or older who have had three or more normal PAP test results in a row and no abnormal PAP test results in the last 10 years may choose to stop having cervical cancer testing.
A women can also decrease her chances of getting cervical cancer by doing certain things to help prevent getting HPV infection. Those include not having sex at an early age, not having multiple sex partners and making diet modifications.
A new method to prevent cervical cancer is vaccines used to prevent HPV infection. The vaccines Gardasil and Cervarix can protect women against certain types of HPV which are likely to cause cervical cancer. Cervarix is approved for use in girls and young women ages 10 to 25 years, while Gardasil is approved for those 9 to 26 years old.
To be most effective, the HPV vaccine should be given before a female has any type of sexual contact with another person. Both are given in a series of three doses within a 6 month period.
The American Cancer Society recommends routine HPV vaccination for girls 11 to 12 years old. HPV vaccination is also recommended for females 13 to 18 years old to catch up missed vaccines or to complete the series.
Therefore, don't take chances with your health. Prevent cervical cancer by avoiding risk factors and taking part in regular screening programs. For more information on cervical cancer, visit the American Cancer Society Web site at www.cancer.org.
Michael Cockerham, M.S., Pharm.D., BCOP is a board certified oncology pharmacist professor and assistant dean at the University of Louisiana at Monroe College of Pharmacy.