Some years ago I was involved in persuading the Maryland General Assembly to pass a law requiring that all women admitted to a hospital be offered a Pap test to screen for cervical cancer. We thought we had made a significant contribution to cervical cancer prevention. But the number of cervical cancer deaths in Maryland is still high. Of the 4,000 women in the United States who will die of cervical cancer this year, about 77 will be from Maryland. Ann Klassen, a researcher at the Johns Hopkins School of Public Health, and Dr. Neil Rosenshein, associate professor of gynecology and obstetrics at the Johns Hopkins School of Medicine, have been looking at this problem, and I recently asked them about it.
Q: Who is at risk for cervical cancer?
A: All women are at risk. Sexually active women, especially those with multiple partners, are at highest risk for developing cervical cancer. However, older women who have not been screened regularly are also at risk. More women past the age of 65 die of cervical cancer than younger women, mainly because they fail to maintain regular screening throughout their lives. All women should have a Pap test regularly as a routine part of a gynecological exam.
Q: What is a Pap test? Does it hurt?
A: The Pap smear is a sample of cells taken from the surface of the cervix and sent to a laboratory to be tested for signs that could lead to cervical cancer. The sample is taken during a routine pelvic exam and can be uncomfortable, but does not usually hurt.
Q: How often should I have a Pap test taken?
A: Most gynecologists recommend annual Pap tests. The American Cancer Society, the National Cancer Institute and the American College of Obstetrics and Gynecology recommend testing at least every three years. The most important thing to remember is that you should be tested starting when you first become sexually active and continuing until your physician says it is no longer necessary.
For more information, call the Maryland State Cancer Hot Line at 1 (800) 477-9774. (You may be eligible for a free Pap test.)
Dr. Matanoski is a physician and professor of epidemiology at the Johns Hopkins School of Hygiene and Public Health.