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Regular Pap Test a Must to Combat Cervical Cancer

By Elizabeth Tracey , MS
WebMD Health News

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 obstetrician/gynecologists."

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 killed.

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 Tampa.

"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.

Vital Information:

  • 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 basis.

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