CANCER-FREE JOURNEY IN THE MENOPAUSAL ZONE: PAP TEST IS THE PASSPORT

By

DR. MRS. Meenal Kumar, M.D. senior gynecologist and menopause consultant, sector 20 civil dispensary, Chandigarh

DR.R.KUMAR M.S., OPHTHALMOLOGIST AND HEALTH COLUMNIST, 232, SECTOR 16, CHANDIGARH

INTRODUCTION

A woman’s chances of developing cancer uterus increase as she matures. About 95 percent of women with this cancer are 40 years old or older. Especially at risk are women who take estrogen, are postmenopausal, are obese, or have a history of breast cancer or of high blood pressure. The deadliest gynecologic cancer attacks the ovaries. While a woman is most likely to survive ovarian cancer if it is found early and treated before it has spread outside the ovary, the disease usually has no symptoms. Only 25 percent of ovarian cancers are diagnosed at this early stage. Now many people know that women with two or more close relatives who have had ovarian or breast cancer may be at high risk for developing ovarian cancer. Current research in reducing the risk of ovarian cancer has been promising. One study demonstrated that oral contraceptive pills, in particular those containing the hormone progestin, can cut the risk of ovarian cancer by 50 percent. One of the most preventable and treatable types of cancer is cervical cancer. New screening methods to detect the cancer at its earliest and most treatable stage have significantly reduced the number of deaths from the disease in this country. To help prevent cervical cancer, researchers are focused on the sexually transmitted disease human papillomavirus (HPV), which appears to increase a woman’s risk for cervical cancer. Currently, one topic under investigation is the role that HPV plays in blood vessel formation, which is essential for the development of cervical cancer. To detect and to help prevent a gynecologic cancer, women need to have a regular Pap smear test and pelvic exam beginning at age 18 or when they become sexually active. The Pap test can detect HPV infection and pre-cancers of the cervix. During a pelvic exam, the doctor will check the ovaries and uterus for any abnormalities in size or shape. Even women who have had their uterus removed and those past menopause still need to have regular Pap tests, to ensure their best health. We shall concentrate on cancer cervix in this write up.

Cervical cancer is the commonest cancer in the female, in the menopausal zone, in India. While early marriage, poor sexual hygiene and growing extra-marital and pre-marital contacts, multiple sexual partners make the occurrence of this cancer common; fortunately this can be detected with a simple test, even before it takes its foothold firmly in the genitals of the victim. The test is called Pap test, which is easy to perform, and is painless and inexpensive. This test has to be performed regularly every year in all females, who are sexually active at or after the age of 18 years. However new guidelines say that it can be postponed till 21 years, and instead of annual test it can be done every 2-3 years, if everything else is normal. Remember that though this cancer is usually investigated and generally found in the menopausal zone, where the history is suggestive of early, excessive and varied sexual activity and or smoking/ drug abuse etc must be examined and investigated properly, in the young age. For that matter one is never too young to ignore PAP smear and other tests, if the conditions are suggestive.

Women who have had a hysterectomy do not need Pap smears unless the hysterectomy was performed for cancer or precancerous conditions. Continue Pap smear screenings for cervical cancer until they are 70 years old. It's important to note that more than 50 percent of diagnosed cases of cervical cancer occur in women who have never had a Pap smear. Another 10 percent of diagnosed cases of cervical cancer occur in women who have not had a Pap smear in the last five years.

What is Pap smear?

Pap smear is a simple test, which any gynecologist can perform. During a pap smear some cells are scraped or brushed off the cervix, and prepared on a slide that is examined under a microscope.  The purpose of the Pap test is to detect changes that may lead to cervical cancer long before cancer develops. Pre-cancer of the cervix is easily treated, and almost always prevents cancer from developing. One may see one of the following in the test: either it will be reported as normal, suspic

1 2 >>