Pap tests give early warning of cervical cancer

By Jasminee Sahoye

Cervical Ribbon
Cervical Ribbon

A regular reader of this column suggested we feature the importance of getting a regular pap test because while a letter came from the Ontario Cervical Screening Program to say her recent test result was normal, she believes women should know that education is the key to prevention.

In my research, I first discovered that cervical cancer starts in the cells of the cervix. The cervix is the narrow passageway connecting the uterus to the vagina.

Evidence suggests that cervical cancer accounts for approximately 1% of all female cancer deaths and it’s estimated that 1,450 women will develop cervical cancer in 2014. One in 149 women is expected to develop cervical cancer during her lifetime. One in 478 will die of it.

According to the Public Health Agency of Canada (PHAC), before cervical cancer develops, the cells of the cervix change and become abnormal.

What are the risk factors for developing cervical cancer? The main one suggested by PHAC is the sexually transmitted human papilloma virus (HPV) that infects the cervix.

Others include becoming sexually active at a young age; having many sexual partners or having a sexual partner who has had many sexual partners; smoking; an immune system weakened from taking drugs after a transplant, or having a disease such as AIDS; using birth control pills for a long period of time and giving birth to many children.

Cancer Care Ontario (CCO) says cervical cancer screening is recommended every three years for all women starting at age 21 who are or ever have been sexually active.

“Sexual activity includes intercourse, as well as digital or oral sexual activity involving the genital area with a partner of either gender. Women who are not sexually active by 21 years of age should delay cervical cancer screening until sexually active. Regardless of sexual history, there is no evidence to support screening women under 21 years of age,” CCO says.

It says that based on the latest clinical evidence, cervical cancer screening every three years is effective. Pap tests can stop at age 70 in women who have had three or more normal tests in the prior 10 years.

If you have had a hysterectomy, talk to your doctor or nurse practitioner to see if you still need a pap test.

According to Dr. Linda Rabeneck, CCO vice-president of prevention and cancer control, for women who have been doing pap tests “it is important to continue to get a pap test in the future because cell changes on the cervix can develop over time. Pap tests can help prevent cervical cancer or catch it earlier when it is easier to treat. Talk to your healthcare provider about when you should have your next pap test.”

Rabeneck says no test is perfect and you should see your healthcare provider if you have unusual bleeding or discharge from your vagina.

So what can you do to reduce the risk of cervical cancer? A CCO recommendation is that you should consider human papillomavirus (HPV) immunization. “The HPV vaccine is available at no charge to all Grade 8 girls through Ontario’s publicly funded school-based program. It is ideal to have the vaccination before becoming sexually active and possibly exposed to the HPV. Women who are already sexually active can also receive the vaccine. The vaccine prevents most but no all cervical cancers.”

“Condoms do not fully protect you from HPV infection but they may reduce the risk. Condoms are effective protection against other sexually transmitted infections. Eat well; follow Canada’s Food Guide and exercise regularly, manage stress and get enough rest to stay healthy.”