OB-GYN’s Crucial Role in Protecting Women from Cervical Cancer

Every year, more than 12,000 American women are diagnosed with cervical cancer, and more than 4,000 of those women die from the disease. And, according to a reevaluation of existing data in a study recently published in the journal Cancer, the cervical cancer death rate may actually be much higher than previously estimated. Since January is Cervical Cancer Awareness Month, now is an excellent time to educate our patients about the steps they can take to not become a part of these terrible statistics.

We know Pap smears are one of the most effective tools we have to improve cervical cancer outcomes. Half of all cases of cervical cancer occur in women between the ages of 35 and 55; it’s rarely found in women under 20, and about 20 percent of cases are in women 65 and older. That’s why we recommend regular cervical cancer screenings in our patients starting at the age of 21 and through the age of 65 or longer based on individual risk factors. Pap smears screen for a cancer that’s often symptomless, and they help spot changes in the cervix before cancer develops—when treatments are most effective. Due to widespread adherence to Pap smear testing, deaths from cervical cancer have decreased by 50 percent over the last 30 years. So, encourage your patients to attend their annual well-woman visits. Along with the opportunity to offer Pap smears and screenings, these visits provide an ideal occasion to educate patients about cervical cancer risks and prevention.

Of course, virtually all cervical cancer cases are linked to HPV. HPV is the most common sexually transmitted infection: 80 percent of all sexually active people will contract the virus in their lifetimes. A family history of cervical cancer increases the risk two- to three-fold, since these women may have a genetically inherited condition that makes it harder for their bodies to fight off HPV infection. The three-dose HPV vaccine protects against 81 percent of cervical cancer cases. The CDC, AAP, AAFP and ACOG all recommend the vaccine for boys and girls between the ages of 11 to 12 years old. Full vaccination reduces risk of certain HPV-related cancer by up to 99 percent; boosting vaccination rates could prevent 29,000 HPV-related cases of cervical cancer every year.

Vaccine adherence rates, however, remain low, with only about one-third of girls and just over one in 10 boys receiving their full vaccination series. Educating your young patients or those who are parents of preteen children is important. Likewise, it’s important to ask your patients in their teens and 20s whether or not they’ve been vaccinated. Even if a patient missed the recommended vaccine as a child and is sexually active, if she’s under the age of 27, it may still be beneficial because there may not have been exposure to all of the virus strains the vaccine protects against. If a patient refuses vaccination at first, it never hurts to keep offering it at future visits.

Like many things we discuss with our patients, there is still a lot of misunderstanding about HPV and cervical cancer.  That’s why it’s so important to continue to encourage annual well woman visits and HPV vaccinations. For more information to help guide your conversations with patients, visit ACOG’s Immunization for Women website, shotbyshot.org, or the National Cervical Cancer Coalitions Cervical Cancer Awareness Month page.

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About Tom Gellhaus, MD

Tom Gellhaus, MD is ACOG President through 2017. He is a Clinical Associate Professor in the Department of Obstetrics and Gynecology at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. Dr. Gellhaus graduated from Yankton High School in Yankton, South Dakota, received his Bachelor of Arts Degree in Chemistry from Augustana College in Sioux Falls, South Dakota and his Doctor of Medicine Degree from the University of Oklahoma in Oklahoma City, Oklahoma. He completed his residency in Obstetrics and Gynecology at the University of Iowa Hospitals and Clinics. Following residency, he entered private practice in Davenport, Iowa and after 20 years in private practice, he returned to academic medicine at the University of Iowa. Over the past 20 years, Dr. Gellhaus has served in many ACOG positions at the local, regional, national and international levels. Dr. Gellhaus’ interests are in the areas of health care advocacy and policy. He has also been very involved and active in global healthcare. He has completed the McCain Fellowship, a month long in-depth experience in advocacy, at ACOG in Washington, D.C. in 1999. In 2001, he was a Primary Care Policy Fellow with the U.S. Department of Health and Human Services. He has remained active in Advocacy and Policy as a member of ACOG’s Government Affairs Committee and the Ob/Gyn PAC. Dr. Gellhaus has also been very active in leading groups on short-term medical and surgical mission projects for the last 20 years. He has done numerous presentations about these short-term medical and surgical mission projects throughout the United States.

6 thoughts on “OB-GYN’s Crucial Role in Protecting Women from Cervical Cancer

  1. I think the importance of educating women of all ages on cervical cancer prevention will continue to remain a priority in the community of health care for years and decades to come. As a woman and a professional that works within the health care industry, I can appreciate the importance of accurate and up-to-date information that helps women make informed decisions about screenings and preventative care.

  2. I agree with everything you are saying but I feel very strongly that Pap smear screening should not be backed off to 3-5 years. It’s still not that accurate a test. I find also many pts are high risk and don’t remember having dysphasia and job in the past. I also disagree with stopping screening after 65. Almost all of my high grade lesions and cancers have been in that age group since they have acquired new strains of Hpv that they don’t clear as well after being divorced or widowed in middle age. I think it will be like backing off vaccines –all we will see is a reemergence of ceevical cancer which were finally make headway against

  3. Cervix cancer is a preventable disease, it has no reason to be because we can intervene from several points of view:
    1) we can modify the risk factors
    2) we have immunization against HPV
    3) develops very slowly (from an initial lesion until cancer takes many years)
    4) we have the papanicolau test , which is very cheap and easy to perform
    5) colposcopy detects lesions in very early stages.
    Management in the initial stages is very easy to perform and gives us high rates of disease eradication.
    This is why I maintain my position that cervical cancer has no reason to be.

  4. The reference to family history is confusing. It is my understanding that the “FH association” is in part due to social factors that may ‘”run in families” such as smoking, early onset of sexual activity and pregnancy at an early age. Additionally, poverty that may result in poor nutrition has a direct effect on the ability to clear infections in general and HPV specifically. I would like to know the evidence of a “genetic factor that may be inherited”. Can we really control for the confounding social variables? Is there such evidence?

  5. I think it would be more helpful to publish your blog on cervical cancer during January (Cervical Cancer Awareness Month) rather than February. It would have had more impact and mobilized more physician coordinated effort to their patients.
    In any case, your points are well taken.

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