January is National Cervical Health Awareness Month. The "Surveillance Epidemiology and End Results" estimates 11,270 women will be diagnosed and 4,070 women will die from cervical cancer in the United States in 2009. Over the past 40 years, death from cervical cancer has significantly declined. Today, it accounts for only 1 percent of cancer deaths among American women. This decrease is largely due to current screening practices.
Infection by human papilloma virus, or HPV, is the main cause for abnormal changes to cells of the cervix which can lead to cervical cancer. HPV is considered the most common sexually transmitted infection, affecting 50 percent to 85 percent of all sexually active women and men. It can be passed on not only by sexual intercourse, but by any type of sexual contact. However, you can reduce transmission of HPV by decreasing the number of sexual partners in a lifetime and using barrier protection such as condoms.
Women may also be protected from HPV by receiving the Gardasil vaccination. This vaccine offers protection from four of the viral types that cause 60 percent to 70 percent of problems related to cervical cancer and genital warts. The Gardasil vaccination is administered as a three-dose series for women between the ages of 9 to 26, with the optimal starting age of 11 to 12.
If you have already been sexually active, the Gardasil vaccination is still recommended. The likelihood you have been exposed to all four viral types is rare, so you can gain protection from the viral types you have not been exposed to. Even if you are married, it is advised you receive the vaccination. Life circumstances can change (i.e., divorce, death of a spouse, sexual assault), in which case, women could be afforded protection they otherwise would not have had.
Cervical cancer prevention can also be accomplished through a test called the pap smear. This simple test is an effective way to check for cells of the cervix that may not be abnormal. The HPV test is an additional screening which checks for 13 of the high risk HPV types that can be more cancer causing than others.
In November 2009, pap smear screening guidelines were updated. The American College of Obstetricians and Gynecologists now recommend less frequent screening than before. Because HPV effects can take one to three years to be detected, ACOG found that less frequent screening intervals still detected cervical cancer, but also decreased the cost of screening and avoided unnecessary procedures.
The 75th Medical Group follows ACOG guidelines which urges women to begin pap smear screenings at age 21 and every other year through the age of 29. At age 30, if you have had three consecutive normal tests, you may screen every three years. Women age 30 and older may also have the HPV test in addition to their pap smear screening.
Pap smear screening is no longer required for women after the ages of 65 to 70 who have a normal pap smear history, or who have undergone a hysterectomy for noncancerous reasons, where the cervix has been removed. Pap smear screening is also not a requirement for women to receive birth control prescriptions.
Although pap smear guidelines have changed, the screening guideline for another STI, chlamydia, has not. The U.S. Preventive Services Task Force recommends all sexually active females up to the age of 26 be screened for chlamydia annually. The 75th MDG also recommends sexually transmitted infection testing whenever you change your sexual partner. Other STI tests that are available are HIV, syphilis, hepatitis A, B and C, and herpes type 1 and 2.
Although you may not require a pap smear screening every year, women are still encouraged to receive their routine prevention exam annually. The 75th MDG Women's Health Clinic offers a wide variety of services ranging from preconception and birth control counseling to infertility assessment and menopausal management. The clinic treats STIs, and evaluates and treats gynecologic problems such as pelvic pain, abnormal bleeding or vaginal discharge.
The 75th MDG women's health services are open to all Tricare Prime female beneficiaries. You may schedule an appointment by calling (801) 728-2600. The Gardasil vaccination is offered at the 75th MDG Immunizations Clinic. Walk-in hours are Monday, Tuesday, Thursday and Friday from 7:30 a.m. to 4:30 p.m., and on Wednesday from 9 a.m. to 4:30 p.m. (closed from 11:30 a.m.-12:30 p.m. daily).