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January 9, 2007 > Stepping Up the Fight against Cervical Cancer

Stepping Up the Fight against Cervical Cancer

Fifty years ago, cervical cancer was one of the most common causes of cancer-related death for women in the U.S. Today, far fewer women in this country die from the disease. The main reason for the decline: Since 1955, the Pap smear has become part of many women's health care routine, making it possible to detect cell changes that might lead to cancer of the cervix.
Despite this good news, about 9,700 women were diagnosed and about 3,700 died of invasive cervical cancer in the U.S. in 2006, according to American Cancer Society (ACS) estimates. So, it's important that every woman continue following a routine of cervical health care, including regular Pap smear screenings beginning about three years after sexual activity is started, but no later than age 21.
The U.S. Food and Drug Administration (FDA) recommends all women, regardless of the results of their Pap smears, should visit their doctor annually for a pelvic examination, which should include checking the reproductive and other organs for abnormality in shape or size.
"We know that, years before a woman develops cervical cancer, she develops precancerous lesions called dysplasia," explains Elizabeth Kurkjian, M.D., an obstetrician and gynecologist with Women's Health Specialists in Fremont and a member of the medical staff at Washington Hospital. "The Pap smear is very good at detecting these changes."
A virus and can lead to cancer
The most common risk factor for cervical cancer is the human papilloma virus (HPV), a group of more than 100 different viruses. The ACS reports that some types of HPV cause genital warts, others cause cervical cancer. HPV is passed from one person to another during sexual relations.
HPV is a very prevalent infection. An estimated 80 percent of sexually active women will be exposed to it during their lifetime, Dr. Kurkjian states. Fortunately, HPV leads to cancer only rarely. The body's immune system usually fights off the infection. Notably, tests show that all women who have cervical cancer have been exposed to HPV. Clinical testing to detect HPV has been available for about ten years.
One new development is that doctors are using what they've learned from testing a woman for HPV and combining it with Pap smear testing results to determine who is at high risk for cervical cancer. Currently, recommendations vary on who should have HPV screening and when it should be done.
"The bottom line is, every woman should be aware that HPV is an inciting factor for cervical cancer and should talk to their doctor about whether testing for the virus is a good option for them," says Dr. Kurkjian.
New Vaccine
Last year, a new HPV vaccine called Gardasil was approved for use by the FDA. The vaccine protects against four types of HPV, including two types that cause about 80 percent of cervical cancers and two types that cause about 80 percent of genital warts.
"This is very exciting news," continues Dr. Kurkjian. "Gardasil doesn't protect against every HPV strain, but it is a very big step."
Merck & Co., the drug's manufacturer, recommends that the vaccine be given to girls and women age 9 to 26, as this is the group most likely to be exposed to HPV. Gardasil is given in a series of three shots at three-month intervals.
The company advises administration of Gardasil to girls beginning at age 9 so that protection can be built up before sexual activity begins. The American Academy of Pediatrics agrees that it is important to give the vaccine before girls become sexually active, but recommends it be routinely given to girls when they are 11 or 12.
"The hope is that, HPV screening to detect precancerous lesions and identify high risk women, along with the use of Gardasil, will prevent HPV-related cervical cancer from occurring," adds Dr. Kurkjian.
"Just remember that screening and vaccination are only part of a woman's comprehensive healthcare routine," she concludes. "Even if a woman is at low risk for cervical cancer, she should keep in touch with her doctor regularly, following all the well-woman recommendations."
To learn more about well-woman recommendations, visit the Women's Health Web page of the U.S. Department of Health and Human Services at and search for "screening recommendations."
HEADLINE: Learn More about Women's Health
You are invited to "Lunch and Learn" classes sponsored by Washington Women's Center to keep you informed about women's health issues. Bring your lunch and join us for these brief, but valuable, sessions starting at 11:15 a.m. and 12 noon:

"Women Friendly Nutrients"
Wednesday, Jan 10
"Cervical Health"
Thursday, Jan. 25

Women's Center Conference Room
Washington West
2500 Mowry Ave., Ste. 150, Fremont

To register, call (800) 963-7070 or Kathy Hesser, R.N., (510) 608-1356 for more information.

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