Cervical Cancer One of the Most Beatable

Among cancers considered preventable and treatable, cervical cancer is seen as one of the top success stories in the medical community.

"The pap test can prevent every new case of cervical cancer," said Dr. John Morgan, a cancer epidemiologist and professor at the Loma Linda University Medical Center. "Any case of cervical cancer is unnecessary because of the pap test."

Morgan said that much like a colonoscopy, a pap test is not designed to detect cancer, but pre-cancerous conditions that can be treated before any cancer forms.

The pap test, recommended once every three years for women 21 to 29 years old, takes cells from both the surface and the inside of the cervix. The cells are then examined for cervical dysplasia, or abnormal growth of precancerous cells. Low-grade dysplasia may not require treatment at all, but high-grade dysplasia can lead to cancer and can be addressed with a variety of treatments, Morgan said. The treatments can be invasive — up to and including a hysterectomy — but early treatment can avoid cancer completely, Morgan said.

The pap test is the main reason cervical cancer incidences and mortality rates have decreased by more than 50 percent in the last 30 years, the American Cancer Society says. Once the most common cause of cancer death for women in the country, approximately 12,000 cases of invasive cervical cancer will be diagnosed this year, with about 4,000 women dying from the disease, according to the American Cancer Society. Still estimates are between 10 and 20 percent of women who can benefit from the pap test do not get regular exams. Morgan said many doctors require such tests during routine physical examinations or before prescribing oral contraceptives. But access to testing and insurance to pay for the tests stops some women from getting recommended screenings. But Morgan said there is another reason some women are not tested.

"I think it is motivation," Morgan said. "Some people just do not take the personal responsibility to get the screenings that can help them."

Morgan said there is a difference between women who don’t get pap tests and men who don’t get testing for prostate cancer.

"It’s different in a very important way. With PSA testing with prostate cancer, we don’t have evidence it saves life. We know the pap test saves lives," he said.

Prevention of cervical cancer has also been boosted by the development of the HPV vaccine, Morgan said. The human papillomavirus, which is spread by skin-to-skin contact, is believed to cause up to 90 percent of all cervical cancer cases as well as other cancers in women and men. But not everyone who has HPV will develop any cancer, and Morgan said most people will at one time in their lives have HPV in their bodies.

The vaccine was approved in 2006 by the Food and Drug Administration. It can be administered as young as age 8, but girls should be vaccinated before they become sexually active. The vaccine has been controversial, with some questions whether it was effective or if it might even cause the cancer. But Morgan said the medical community, particularly the cancer community, widely supports the vaccine.

"The medical evidence, and it is not proof at this point, but we have every reason to believe woman who are vaccinated before they are sexually active, the vaccine will be successful in preventing that cancer,” Morgan said. “But it will not prevent all cervical cancer."