Checklist: Protecting Yourself From Cervical Cancer
(This article was originally published on this website in 2008. It has been updated to reflect current standards related to how cervical cancer screening should be approached.)
The best protection a woman has against cervical cancer is to develop a trusting relationship with a gynecologist and follow the guidelines listed below:
- Regular Exams. Visit a gynecologist at least once a year for a pelvic examination and Pap smear. Request that HPV testing be done as well. Examinations should be more frequent if a woman has noted an abnormality related to her reproductive organs, such as a change in menstrual regularity, odor or vaginal drainage, painful intercourse, etc. After three normal Pap smears and if HPV * negative, less frequent screening is necessary.
- Report Changes. Report all changes to the gynecologist, including specific reasons for the visit and any changes in function which have occurred since the last visit.
- Agree On Testing Practices. Insist that the gynecologist personally contact the laboratory that evaluates the Pap smears and establish that the Pap smear will be evaluated by a physician with special expertise in cytopathology.
- Agree On Reporting. If an abnormality is reported on a Pap smear, insist that the gynecologist discuss the results directly with the physician who made the interpretation to completely understand the conclusion.
- Repeat Tests. Insist that any repeat Pap smears be performed within three months. If any abnormality persists on a repeat Pap smear or where a Pap smear is abnormal and you are HPV+ as well, ask to have a magnified visual inspection of the cervix conducted by a gynecologist skilled in the performance of colposcopy.
- Sample Tissue. Even if no visible abnormality of the cervix is seen during the colposcopy, one may exist in the endocervical canal, a part of the cervix that cannot readily be seen by colposcopy. Therefore, a sample of the tissue in the canal should be taken to look for any abnormalities revealed by earlier Pap smears but not necessarily visible upon magnified inspection of the cervix. Pap smears which do not contain endocervical cells should be repeated to ensure that the test could detect abnormalities in the endocervical canal, if they exist. Consider having a biopsy of any abnormality seen on the cervix during colposcopy. Take note, however, that biopsies can carry an increased risk of cervical incompetence and certain patient populations, such as women under the age of thirty and women who are negative for HPV, stand a greater chance of specific cervical abnormalities regressing without treatment. Talk with your doctor about the risks and benefits of a biopsy for your type of cervical abnormality.
- Ask For A Clear Diagnosis. A biopsy showing dysplasia or cervical intraepithelial neoplasia or CIN II or higher, or described as a high-grade squamous intraepithelial lesion requires specific treatment; insist on it. If you don’t understand the words, ask your gynecologist to explain it to you in words you can understand. Any precancerous condition must be treated immediately. Don’t accept “let’s wait and see how it looks next year.”
- Gardisil vaccination. Children both male and female should be vaccinated with Gardisil prior to becoming sexually active.
*HPV stands for human papilloma virus. It is common in sexually active multi-partner patients. Most of the time the virus resolves without treatment. However, the persistence of the virus is the known cause of most cervical cancer.
Modern medicine offers many therapeutic treatments to women diagnosed with invasive cancer. Prevention, however, is far better than cure.