One month ago I had my uterus and cervix removed in large part because of my medical history. My medical history that already includes one malignancy. My medical history that excludes me from the regular population of healthy 37 year old women. My history that has included more birthdays, year after year, as a survivor of Hodgkins Disease.
The interesting thing about the timing of my hysterectomy is that it came when the American Cancer Society (ACS) published it’s new guidelines for Cervical Cancer screening. Screening guidelines intended for the population of women that are not at risk for whatever reason. Screening guidelines that are meant to educate and inform women everywhere. Screening guidelines are different than guidelines for management of known health issues.
The new guidelines take into account research from various studies. The guidelines are intended to educate women and reduce the risk of complications that can arise from screening tests while still providing timely and efficient screening parameters.
The new guidelines for cervical cancer screening are:
Cervical cancer screening should beginning at age 21.
Women between the ages of 21 and 29 should have a PAP every THREE years. HPV testing should not be used unless it is needed after an abnormal Pap test result.
Women between the age of 30 and 65 should have a PAP PLUS HPV test every FIVE years.
source: American Cancer Society
Reading the new guidelines the morning that I came out of surgery, admittedly made me wonder if I had done the right thing. But then I remembered. I am not part of the regular population. The guidelines are written for otherwise healthy women, and are intended to balance the need to screen and detect cancers early on with the potential harm that even small procedures may have on child bearing.
I had the opportunity to speak to Dr. Debbie Saslow, the Director, Breast and Gynecologic Cancer, for the American Cancer Society who explained that women associate a pap test with their annual check up. But really, the importance of an annual check up is preventative and the association between the test and the check up need to be unlinked. The results of a 2012 study looked at a comparison to cervical screening in the United States versus the Netherlands indicated that the United States screens more and yet, the mortality rates are the same.
The issue, Dr. Saslow pointed out, is that many women do not go for annual check ups. For reasons of finances, insurance, culture, and geography, screening tests have been suggested historically by doctors to keep women coming back into the doctor’s office. Without the tests, organized health care systems worry that women may not come back. I can attest to this. Spending an afternoon in the emergency room to rule out a complication from my surgery a few weeks ago was eye opening. Patient after patient came in, with colds, soar throats…issues that could be taken care of by general practitioners. Unless of course, you don’t have one. Or don’t go often enough.
Clearly testing and screening is a good way to detect issues. But with testing com the emotional ups and downs that are associated with waiting for the results, following up “abnormal” responses, and the potential for scarring that may result. Preventative health care IS important. In my personal case, I have always erred on the side of caution, screening and testing without a concern for the possible consequences.
But the truth is that more is not necessarily better. Unnecessary procedures happen every day. Which is why being educated about the guidelines is so important. Asking questions of our doctors is the best way that we can advocate for ourselves. Our health is OURS to manage.
Testing is not always the answer. The key is prevention and knowledge. My doctors tend to jump the gun with me, preferring to rule out anything and everything because of my history. I have a medical history that includes cancer. Not everyone does. Each of us is different and needs to make individual decisions based on our personal and familial factors. As the ACS says, “Take control of your health, and reduce your cancer risk.”
I am a member of the American Cancer Society Blogger Advisory Council. Cancer, More Birthdays, and Cancer Screenings are important to me.