Cervical Cancer Prevention Saves Lives and it Saves Money.

Cervical Cancer Prevention Saves Lives and it Saves Money.

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Why get the PAP every year?                                             

I hate pelvic exams...   Before the PAP smear, now more often the PAP test, was developed by Dr. Papanicolau, cervical cancer was the number one cancer killer of women around the world.  To this day, in countries where reproductive health services are limited and funds are scarce, it remains one of the most common causes of  “women’s” disease and the ONLY cancer that is almost 100% preventable from annual screenings and, now, vaccination.

The purpose of the PAP was to identify cell changes in the squamous cells (surface skin cells that line the throat, the skin,  the penis, the cervix, the vagina, and the ano-rectal opening, for example.)  Cells that have higher levels of keratin, such as the ones listed, are more prone to infection.  Keratin helps make these surface cells more durable, and able to withstand force and pressure from contact with the outer world (finger tips) to bodily functions such as swallowing, sex, child birth and bowel movement.

Do I have to understand what HPV is about?  Isn't it about sex? 


These cell changes signified the future development of tumors if caught early, and cancer if caught late.  Although there was no known cause of this cancer at the time, routine screening through the PAP smear was the only way that women could prevent death from cervical cancer.  Caught early and treated with LEEP or culposcopy, or later with hysterectomy (as is often the case with peri and post menopausal women who have had their children), cervical cancer deaths declined in the places of the world where women had regular, annual access to a PAP- and good providers and lab services to perform the procedures properly.

It was not until the 1990’s that PCR DNA analysis helped pathologists identify the root cause of most cervical dysplasia and tumors.  HPV virus- humanpapillomavirus- is a family of viruses that selectively infects human keratinocytes (high keratin squamous cells)- and is the cause of all skin warts, genital warts and almost all cervical cancer.  The various strains of HPV can be identified by the HPV test- another test that can be performed at the time of the PAP test- to determine which one or ones is there.  Certain strains are more common, but there are many.  Some are associated with highly carcinogenic activity, and some are associated predominantly with genital warts.  Recent research has now linked HPV virus as the root cause of over 60% of throat cancer, and one of the leading causes of ano-rectal cancer in women and men.

What if we always used condoms?  


The cause of acquisition is contact between two people and the surfaces that carry the virus.  For most of us, that means penis-vagina sex.  It is estimated that between 70 and 80% of sexually active human beings have had this virus at least once in their lifetime.  Some folks are infected with multiple strains.  There are NO KNOWN signs or symptoms of infection in men for the strains that do not lead to wart formation.  They are silent carriers.  As a primary care physician, I can tell you that many men carry warts- tiny little condylomas- around on their penis that they cannot see but are, in fact, visible to the eye.  No one can see the HPV virus or cancer changes until it is well developed.

There are only two ways of preventing infection that we know of:  100% abstinence for all forms of human sexual contact, including oral (or anal) sex as either a giver or receiver.  The other is vaccination of pre-pubescent children- with the hopes that they have not been exposed from a molester or already become sexually active.  Most parents provide sex education to their child after they have already engaged sexual activity.




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