The year of the COVID-19 pandemic has had an impact on our everyday lives. Routine decisions and choices are not necessarily so routine anymore.
Patients may ask, “Can I safely receive preventive screenings during a pandemic? What are the consequences of delaying preventive screenings?” The American Cancer Society estimates that 13,800 new cases of invasive cervical cancer will be diagnosed, and an estimated 4,290 women will die from cervical cancer in 2020.
There can be consequences to delaying much needed screenings.
There are ways to safely obtain a pap smear during a pandemic. First, contact your health care provider to inquire as to what safety measures have been put in place in the office for in-person services. Some of the measures should include face coverings on all staff and patients within the facility, social distancing reminders, and hand sanitizer stations are just a few. Some health care providers are also checking temperatures and asking questions regarding COVID-19 exposure.
Do not delay your cervical cancer screenings. Cervical cancer if detected in the earlier stages can be treated effectively and potentially cured. Early detection is the best protection. Some of the warnings signs of cervical cancer are:
- Abnormal vaginal bleeding, such as bleeding after vaginal sex, bleeding after menopause, bleeding and spotting between periods, or having (menstrual) periods that are longer or heavier than usual.
- An unusual discharge from the vagina − the discharge may contain some blood and may occur between your periods or after menopause.
- Pain during sex
- Pain in the pelvic region
The American Cancer Society recommends cervical cancer testing (screening) begin at age 25. Those aged 25 to 65 should have a primary Human Papillomavirus (HPV) test every five years. If primary HPV testing is not available, screening may be done with either a co-test that combines an HPV test with a Papanicolaou (Pap) test every five years or a Pap test alone every three years.
True or False
- Women who do not plan on having any more children can stop screening for cervical cancer.
- Women who have had a hysterectomy but still have a cervix should continue to follow the American Cancer Society screening guidelines for cervical cancer.
- Women who have been vaccinated for HPV do not require cervical cancer screening.
- Screening can also actually prevent most cervical cancers by finding abnormal cervical cell changes (pre-cancers).
If an abnormal pap smear is determined, additional testing would include a return to the doctor’s office for a medical history and a physical examination. The physical exam may include a pelvic examination to palpate any enlarged lymph nodes which could signal metastasis to other areas of the body. If the Pap smear is positive or if the HPV test is positive, a procedure known as a colposcopy will need to be done.
A colposcopy is a procedure that allows the doctor, using a magnifying scope and acetic acid (vinegar), to visualize the abnormal cells and to remove pieces of the abnormal cells with a special instrument, for biopsy.
There are several procedures that allow a doctor to remove and biopsy abnormal cells, the colposcopy is the most common.
Depending on the result of the biopsy and the depth of the abnormal cells, endocervical scrapings with a curette or a brush may be used to collect the samples as well as remove the abnormal cells. A cone biopsy is another procedure that may be selected to remove the abnormal cells.
Other tests that may be needed if a cervical cancer diagnosis is made may include a chest x-ray to determine if the cancer has spread to the lungs, a CT scan and or an MRI are additional tests that may be gathered to determine the extent of the cervical cancer.
The goal of cervical cancer screening is detecting abnormal cells in the precancerous stage by obtaining a pap smear and HPV screening. Women can obtain the HPV vaccine up to 26 years of age.
According to the American Cancer Society, the goal of cervical cancer screening is to find pre-cancer or cancer early when it is more treatable and curable.
Regular screening can prevent cervical cancers and save lives. The tests for cervical cancer screening are the HPV test and the Pap test. Pre-cancerous changes can be detected by the Pap test and treated to prevent cancer from developing.
The HPV test looks for infection by high-risk types of HPV that are more likely to cause pre-cancers and cancers of the cervix. HPV infection has no treatment, but a vaccine can help prevent it.
The bottom line is that even in the midst of a pandemic that has upended normal life preventive screening for cervical cancer is too important to delay.
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