Pap Testing, HPV and Cervical Cancer
Saturday, 04 April 2009 16:28
Jade Goody is a British reality TV ‘celebrity’ who is currently going through the terminal stages of cervical cancer at the age of 27. Since receiving her diagnosis live on Indian television she has chosen to continue to go through her suffering in public. Whatever the rights and wrongs of this, the effect in the U.K. has been a startling rise in requests for Pap Tests.
The Pap Test is the best way to screen for cervical cancer in women. It is important because this is one of the few cancers that can be stopped from developing in the first place simply by detecting and treating pre-cancerous cell changes. Uniquely, it is the only cancer so far that may be entirely preventable with a vaccine.
What is a Pap Test?
Named after George Papanicolaou who developed the test in the 1930s, it involves an internal gynaecological examination. A sample of cells is taken from the surface of the cervix (neck of the womb) and either spread on a microscope slide or put into special liquid then sent to the laboratory for analysis. The liquid based test (ThinPrep) is newer and can also be used to test for some infections including human papilloma virus (HPV).
What is HPV?
There are lots of different strains of the human papilloma virus. Some are associated with developing clinical warts, some with an increased risk of cervical cancer. HPV is spread by sexual contact. Most women infected with HPV will not develop cervical cancer but some women with HPV will go on to have cell changes that with time could become cervical or vaginal cancer.
Who Needs a Pap Test?
Testing should begin when women reach the age of 25, or three years after first sexual intercourse, whichever happens first. The test should be repeated at regular intervals until you reach 65 and the last three tests have been normal. Women of 65 who have never had a Pap Test and who have been sexually active should still have one done. There is debate on how often the test should be done and protocols vary from country to country. If you have had a significantly abnormal Pap or have HPV you should have an annual test. If not the test should be done every two to three years. If you have had an abnormal Pap Test you should ask your doctor for an HPV Test. It is important that a reputable, reliable laboratory is used for these tests.
Who Does Not Need a Pap Test?
Women who have never had sex, women over 65 whose last three consecutive Pap smears were normal, women who have had their cervix and uterus removed, ie. a total hysterectomy (and it was performed for a reason other than cervical cancer), and finally men!
Vaccinating against HPV
Around 70 percent of cervical cancers are caused by HPV types 16 and 18. The remaining 30 percent are probably associated with the other high-risk types of HPV, making this disease pretty much sexually transmitted. There are now two vaccines that protect against HPV. ‘Gardasil’ has been developed to protect against HPV types 16 and 18 – the commonest high risk types – and also types 6 and 11 which cause clinical warts. ‘Cervarix’ only protects against types 16 and 18 but is significantly less expensive. They are both licensed for use in women under the age of 26. Some countries such as the U.S., Australia and the U.K. now routinely include these vaccines for all girls around 11-12 years of age. They are both licensed for use in women under the age of 26 and are available in Cambodia. It will probably only be a matter of time before they are licensed for boys as well as girls.
If you have already had warts or have tested positive to HPV it is still worth considering the vaccine as you may only have had one type and can be protected against the other types. Aggressive tumours in the very young, like Jade Goody’s, are fortunately very rare. Jade’s final legacy to the world may be to save many lives through an enhanced awareness of how vitally important it is to get this simple test performed on a regular basis. Your doctor can discuss this with you.
What is a Pap Test?
Named after George Papanicolaou who developed the test in the 1930s, it involves an internal gynaecological examination. A sample of cells is taken from the surface of the cervix (neck of the womb) and either spread on a microscope slide or put into special liquid then sent to the laboratory for analysis. The liquid based test (ThinPrep) is newer and can also be used to test for some infections including human papilloma virus (HPV).
What is HPV?
There are lots of different strains of the human papilloma virus. Some are associated with developing clinical warts, some with an increased risk of cervical cancer. HPV is spread by sexual contact. Most women infected with HPV will not develop cervical cancer but some women with HPV will go on to have cell changes that with time could become cervical or vaginal cancer.
Who Needs a Pap Test?
Testing should begin when women reach the age of 25, or three years after first sexual intercourse, whichever happens first. The test should be repeated at regular intervals until you reach 65 and the last three tests have been normal. Women of 65 who have never had a Pap Test and who have been sexually active should still have one done. There is debate on how often the test should be done and protocols vary from country to country. If you have had a significantly abnormal Pap or have HPV you should have an annual test. If not the test should be done every two to three years. If you have had an abnormal Pap Test you should ask your doctor for an HPV Test. It is important that a reputable, reliable laboratory is used for these tests.
Who Does Not Need a Pap Test?
Women who have never had sex, women over 65 whose last three consecutive Pap smears were normal, women who have had their cervix and uterus removed, ie. a total hysterectomy (and it was performed for a reason other than cervical cancer), and finally men!
Vaccinating against HPV
Around 70 percent of cervical cancers are caused by HPV types 16 and 18. The remaining 30 percent are probably associated with the other high-risk types of HPV, making this disease pretty much sexually transmitted. There are now two vaccines that protect against HPV. ‘Gardasil’ has been developed to protect against HPV types 16 and 18 – the commonest high risk types – and also types 6 and 11 which cause clinical warts. ‘Cervarix’ only protects against types 16 and 18 but is significantly less expensive. They are both licensed for use in women under the age of 26. Some countries such as the U.S., Australia and the U.K. now routinely include these vaccines for all girls around 11-12 years of age. They are both licensed for use in women under the age of 26 and are available in Cambodia. It will probably only be a matter of time before they are licensed for boys as well as girls.
If you have already had warts or have tested positive to HPV it is still worth considering the vaccine as you may only have had one type and can be protected against the other types. Aggressive tumours in the very young, like Jade Goody’s, are fortunately very rare. Jade’s final legacy to the world may be to save many lives through an enhanced awareness of how vitally important it is to get this simple test performed on a regular basis. Your doctor can discuss this with you.
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