Regular Pap Test a Must to Combat Cervical Cancer
May 30, 2000 -- Elderly, single, or uninsured women are more likely than
other women to have more advanced cervical cancer when they are diagnosed. This
is bad news because how advanced a cancer is when it is first diagnosed has a
lot to do with how likely you will recover.
"Clearly, these women need to be targeted for education and screening
programs," study co-author Jeanne Ferrante, MD, tells WebMD. "I also
believe more family physicians and internal medicine physicians need to be
involved in doing Pap smears, since elderly women don't routinely see
The fact that women who are uninsured are at greater risk for more advanced
stages of the disease is no surprise because uninsured people tend not to see
health care providers regularly, says George Huggins, MD, director of
obstetrics and gynecology at Johns Hopkins Bayview in Baltimore. "Unmarried
women may be at greater risk because they frequently have more sexual partners
than women who are married," he tells WebMD. "This makes them more
likely to become infected with human papilloma virus, which we know is
associated with cervical cancer." Huggins reviewed the study for WebMD.
In 1998, nearly 14,000 women were diagnosed with invasive cervical cancer,
and 5,000 women died of the disease. Unfortunately, almost half of these women
were diagnosed when the cancer was advanced and had already spread to other
parts of their bodies.
Cervical cancer is one of a few cancers that, if detected early, has a very
high survival rate. It is also one of a few cancers that has an effective
screening tool. The Pap smear can detect precancerous cells years before they
can cause cancer. When Pap smears are performed regularly, these cells can be
Women not receiving regular Pap smears are unaware of precancerous cells and
therefore at higher risk for invasive cervical cancer.
"Unfortunately, women who are 65 or older mistakenly think they don't
need routine Pap smears," Ferrante says. "They do need to continue to
receive regular Pap smears, although that may not mean yearly. For women who
have never had an abnormal Pap smear or have had a single one several years ago
followed by normal smears, less often is probably OK. For those with abnormal
smears, however, a yearly Pap smear is still a good idea." Ferrante is
assistant professor of family medicine at the University of South Florida in
"It's true that women aged 65 and older don't get as many Pap smears,
although they may still be at risk for cervical cancer," says Huggins.
"In our practice, we attempt to target women who may be at higher risk,
such as smokers and those with a history of abnormal smears."
Ferrante and colleagues examined data on cervical cancer from 1994 in more
than 800 Florida women. They correlated this with data from the U.S. Census and
other sources to determine which factors were linked to cervical cancer that
was diagnosed at a later stage. Their results were published in the current
issue of the journal Archives of Family Medicine.
- It is important to diagnose cervical cancer in the early stages because it
will mean a better outcome for the patient, but new research shows that women
who are elderly, unmarried, or have no insurance are more likely to be
diagnosed with late-stage cancer.
- Researchers say these women should be targeted for education about getting
a regular Pap smear.
- Women over 65 may not need a Pap smear every year, depending on their
medical history, but they should continue to receive them on a regular