By David M. Shobin, MD
Did you know that cervical cancer is more curable than ever? When Dr. George Papanicolaou developed the Pap “smear” fifty-seven years ago, a test that still bears his name, cervical cancer was the second leading cancer for women in the United States in incidence and mortality. Today, cervical cancer ranks eleventh in incidence and thirteenth in mortality largely due to advances in screening and detection. A Pap test is a microscopic examination of the cells of the cervix for malignant or pre-malignant changes.
The newest tool in the health care professional’s armamentarium is the ability to diagnose the presence of HPV. For the past fifteen years, doctors have known that cancer of the cervix is an STD, a sexually transmitted disease caused by a type of human papilloma virus, known as HPV. Of the hundred-or-so strains or types of HPV, only a handful are related to cervical cancer. These are called the “high risk strains” and can be detected by specific testing at the same time the Pap test is performed.
Today’s Pap tests aren’t really smears at all. Rather, the cervical specimen is collected on a brush and placed in a liquid medium. HPV testing is done on the same liquid in the vial, and the results of both are available within a week. As a gynecologist, I recommend that sexually active women, especially those over thirty, have yearly Pap and high-risk HPV testing. Infection with HPV is very common, and at least seventy-five percent of sexually active women will contract HPV in their lifetime. In such patients, results of the Pap smear, together with HPV testing, can guide health care practitioners toward proper evaluation and treatment.