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Saturday, April 9, 2011

Cervical cancer: Pap Based on only for the prevention of cancer can kill you

Although the test itself usually leads to no harm, you do not know about Pap tests and excessive dependence on reassuring results may be seriously harmful to health. This, in fact, can kill. The reasons for this apparently surprising statement and other basics that a clever woman should know in relation to the prevention of cancer are the subject of this article!

Let's take a brief historical detour just to see why. The Pap test, abbreviatedPap test is a scraping of cells from the cervix with a small spatula and brush. These cells are then scraped review under the microscope for abnormal or precancerous cells. The Pap test has been around for about 50 years and was a breakthrough in preventing cervical cancer. Even today, as nearly 50% of cervical cancers in the United States occur in women who have never been subjected to 60% of cases develop in women who were not selectedat least 5 years, an argument that was made ​​popular periodic review of all women would further reduce the overall incidence of cervical cancer, and possibly eliminate it. "And true that each type of test is better than no choice at all.

But unfortunately, even when the Pap test is readily available, this can not alter the results. In one example, the projection was made ​​in 63% of women under 45 years died of cervical cancercancer in Scotland from 1982 to 1991. Other reports note that up to 20% of women with severe pre-cancer or invasive cervical cancer had normal Pap test in the previous year. It therefore appears that the standard Pap test may not be sufficient to prevent cervical cancer. Many women have symptoms and up to half have been recently examined with Pap tests at least standard frequency.

The conclusion is that, despite its largecontribution to the prevention of cervical cancer, we now know that the conventional Pap test has its limitations dangerous. Using biopsy as the gold standard of best available, the ability of the Pap test to take an early pre-cancer and cancer may be as low as 20% - 30%. In other words, up to 80% of pre-cancerous changes can be lost if based on the Pap test alone. Used alone, is simply a technology of yesterday or the last century.

By the way, if you areexperienced symptoms such as abnormal bleeding bleeding between periods or after sex, please call your doctor immediately. A biopsy is needed for evaluation and possible, not Pap tests or other screening tests. Research is defined as the search for disease in asymptomatic patients. If you have symptoms, it is past that point. While abnormal bleeding is usually due to many possible reasons for benign non cancerous, you owe it to yourself to be completelyevaluated.

It is very important to detect cervical lesions when they are still pre-cancerous. When abnormal cells are scraped from the cervix with a Pap test and looked at under a microscope, it usually means that there is an area of ​​dysplasia or cancer of the cervix before. In some cases it may also be an early cervical cancer. Cervical cancer rarely spread directly from one area to normal. Instead, it develops over time, usually years.The cells become increasingly anomalous and, lastly, invade or begin to grow more than the normal cervical tissue. When these cells invade, are not pre-cancer and invasive cancer is already present.

Once found, before they become invasive or cancerous lesions are not a threat to life and are usually treatable with minimally invasive therapies. In other words, hysterectomy and more drastic treatments such as radiation and chemotherapy are avoided.

CriticalStatement: We now know that there is a sexually transmitted virus called HPV or human papilloma virus-which is largely responsible for almost all cervical cancers, and we have a simple test for this painful! Not perfect but fairly accurate.

HPV is actually quite common, and most (up to 75% or three out of four) women who were sexually active tend to be infected at some point in their lives.

There are two types of HPV: low risk and highrisk. There are several subtypes of each category, but the important thing to remember is that persistent infection with high-risk HPV that put them at higher risk of developing pre-cancerous condition or cancer of the cervix. The good news is that relatively low-risk HPV rarely causes cancer, but can still cause problems such as the cervix, vulva or genital warts, which can be difficult to treat sexually transmitted. The most positive news is that HPV infections are transient. In other words, they go on their own, usually within nine months to a year. However, since this is a sexually transmitted virus, may become infected by contact with an infected person or a promiscuous lifestyle. Therefore, especially if you are enjoying the active sexuality, this is very important.

The bad news is that persistent infection with high-risk HPV is the most important factor is a condition that can develop cervical> Cancer. Note that not all persistent HPV infections develop cervical cancer. In fact, most women do not develop cancer or precancer. However, the increased risk and should put a red flag is important to carefully with your doctor. Actually diagnosed and treated for pre-cancer or cervical cancer in the past, this is proof that you have had a persistent HPV infection and thereforemore likely to have recurrent infection and / or disease.

The second bad news is that there is no currently approved treatment for HPV infection risk. However, since they usually disappear spontaneously this bad news is not so bad for most women. In addition, a commercially available vaccine has just been made available. The ideal time for vaccination is before sexual activity begins, so that between 8 and 13 years is ideal. However, although there is no agreement on the incompletethis, women under 26 years can benefit from the vaccine.

Women who are infected with HIV or are immunosuppressed for other diseases or medications are less likely to have HPV infections disappear spontaneously. Therefore, have an increased risk of descending to the pre-cancer or cancer of the cervix.

The HPV virus is sexually transmitted, as indicated. Contact with the genitals in some way has to happen. However, given the variable length of time requiredto clear the infection spontaneously, the infection does not mean that your partner has been unfaithful. The virus can live on inanimate objects for a short period, contact with sex toys or other forms of indirect contact sexual transmission is possible.

Like everything else, there is an advantage and a risk associated with HPV testing. The main advantage is one of tranquility. If HPV is negative, the risk of dysplasia or cancer is extremely low. The main advantage is secondone of convenience, since the detection range can be easily extended to three years instead of yearly visits. However, to be complete, there are other reasons to go to a doctor once a year for the care and women. The main risks of the HPV test are related to anxiety and psychological stress to know about HPV infection and wondered how he had the infection, since it is primarily a sexually transmitted virus.

Critical Statement: Warning: Ifare one of the first pre-cancer can disappear on its own under medical supervision. During the treatment is possible and can lead to scarring, pain and infertility. Of course, the treatment of HPV infection alone (ie no abnormal cells detected) by surgery (including burning cutting and freezing) is not effective and may lead to more harm than good. Discuss the risks and benefits of treatment with your doctor. If you are not satisfied with the answers, get a secondOpinion!

Critical statement: condoms do not prevent male-female sexual transmission of HPV. The reason for this is that the virus may be living in the scrotum of sexual partners. Moreover, an anti-spermicide nonoxynol-9 has no effect against HPV.

Critical statement: As for other gynecologic cancers are concerned, the Pap test has been designed and promoted to detect these. Period. End of story! Do not let anyone tell you otherwise.The HPV test is only intended as a tool for cervical screening. Technology ovarian cancer detection and uterus are being developed, but are woefully inadequate.

So what cervical screening test (s) should ask for more?

The following information is based on recommendations from the American Cancer Society, it includes my review of the literature and practical experience. In all cases, this means that theserecommendations are as aggressive as it is reasonable to obtain the best prevention. The truth is that what you need is a little individual and depends on age and personal medical history. There is no single answer "cookie-cutter for every woman and you should discuss the details with your doctor.

Can be tested more often than the recommendations given below, but there was no benefit on the basis of extensive medical studies. And there can be some damage. Why? WhyCervical cancer screening is not. Rather, it is pre-cancer. Because of this, usually are not years of built-in time to change events of pre-cancer to cancer, or not. Remember that some of these pre-cancerous changes disappear by themselves. Then, an excess of detection and drug treatment can lead to more harm than good. This is very different from the recommendations on breast cancer screening, where the goal of annual mammographyis to detect cancer early, no pre-cancer. In this situation, the first detection and treatment faster, the better the results. Breast cancer is not going away by itself. Therefore, you see there is a big difference, depending on what you are looking for the detection or prevention.

If you are under 30 years:


You should have your first screening test for about three years after the first sexual contact, regardless of whether or not vaginalpenetration occurred, or 21 years old
You should have a Pap test every 3 years, while they are under 30 years
If the result of the Pap smear shows atypical cells of undetermined significance, also known as ASC-US, you must be screened for the virus high-risk human papillomavirus (HPV) should be
If you are between 30 and 65: both cytology and HPV testing should be obtained yearsIf three has more than 65 years, routine testing is not recommended if you haveadequate screening with Pap smears and testingIf recent and / or HPV had a total hysterectomy or total (which means the cervix is ​​removed):


If the hysterectomy for benign reasons, screening is not recommended vaginal
If the hysterectomy was performed for cervical precancerous results, three tests on consecutive Pap screening should be done before stopping other controls.
If the hysterectomy was done for cervical cancer, thedetection times and frequency of follow-up examinations and vaginal individualized and should be decided in consultation with the gynecologic oncologist.
If you have received treatment for precancerous lesions of the cervix and has not been removed:

Pap and HPV testing was performed 6 months after treatment and repeated after 2 years. If it is normal after these two tests, routine screening depends on the age as mentioned above can be resumed. If you have HIV or who are immunologicallysuppressed by disease or drugs: annual Pap test and HPV test should be performed.
What happens after an abnormal Pap or HPV test?

If cytology is ASC-US and HPV is negative:


Repeat after two years
If it is normal at this time, you can return to routine screening depends on the age, as mentioned above.
If the Pap test is normal, but HPV is positive:
Repeat every year for two years
Is it normal after these two tests, you can return to the old routineselection of employees as mentioned above.
Another visual test called a colposcopy, biopsy and possible, is / are recommended if:
Pap smear shows cells that are worse than ASC-US
Pap test showing ASC-US and HPV is also positive
The HPV test is often positive, the Pap test has been, and remains normal. There is some controversy in this situation, with some expert advice before evaluating other great visuals. In many cases, not found, but alsoa visual security and biopsies may be useful. In these situations, it is best to discuss all the risks and benefits with your doctor for a long time.

Summary of recommendations:


Getting tested
Be tested using a combination of Pap and HPV testing with the above guidelines
Report any abnormal discharge or bleeding symptoms to the doctor early, and insist on an explanation
I do not think that the Pap smear, HPV testing and routinepelvic examination reliably prevent other types of cancer
All the above information is designed to help you make informed decisions about the detection, prevention and health. Not intended to replace the relationship between doctor and patient, as each individual situation is different for health. If you do not have a doctor who can discuss these issues, get one! His health continued to depend on it!

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