January is Cervical Cancer Awareness Month. In observance of this important health month, the American Cancer Society offers information on cervical cancer detection and prevention.
Cervical cancer was once one of the most common causes of cancer death for American women. Between 1955 and 1992, the number of cervical cancer deaths in the United States declined by 74 percent. The main reason for this change is the increased use of the Pap test, a screening procedure that permits diagnosis of preinvasive and early invasive cancer. The death rate from cervical cancer continues to decline by about 2 percent a year.
Cervical cancer deaths are higher in populations around the world where women do not have routine Pap tests. In fact, cervical cancer is the major cause of cancer deaths in women in many developing countries. These cases are usually diagnosed at an invasive late stage, rather than as precancers or early cancers.
Despite the recognized benefits of Pap test screening, not all American women take advantage of it. Between 60 percent and 80 percent of American women with newly diagnosed invasive cervical cancer have not had a Pap test in the past 5 years, and many of these women have never had a Pap test. In particular, elderly, African-American, and low-income women are less likely to have regular Pap tests.
About 13,000 cases of invasive cervical cancer were diagnosed in the United States in 2002. Some researchers estimate that noninvasive cervical cancer (carcinoma in situ) is about four times more common than invasive cervical cancer. About 4,100 women died from cervical cancer in the United States in 2002.
Risk factors for cervical cancer include:
·     Age. The average age of women newly diagnosed with cervical cancer is between 50 and 55 years old.
·     Certain sexually transmitted diseases, particularly Human Papillomavirus, chlamydia and HIV.
·     Smoking.
·     Diet.
·     Low income. Women with lower incomes tend to have less access to adequate healthcare.
·     Diethylstilbestrol (DES) exposure before birth. DES is a hormonal drug prescribed between 1942 and 1971 for women at risk of miscarriage. About one percent of women whose mothers took DES during pregnancy develop cervical cancer.
·     Family history.
The American Cancer Society recommends the following guidelines for early detection of cervical cancer:
·     All women begin cervical cancer screening about three years after they begin having vaginal intercourse, but no later than when they are 21 years old. Screening should be done every year with the regular Pap test or every two years using the newer liquid-based Pap test.
·     Beginning at age 30, women who have had three normal test results in a row may get screened every two to three years. Women who have certain risk factors such as diethylstilbestrol (DES) exposure before birth, HIV infection, or a weakened immune system due to organ transplant, chemotherapy, or chronic steroid use should continue to be screened annually.
·     Women 70 years of age or older who have had three or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years may choose to stop having cervical cancer screening. Women with a history of cervical cancer, DES exposure before birth, HIV infection or a weakened immune system should continue to have screening as long as they are in good health.
·     Women who have had a total hysterectomy (removal of the uterus and cervix) may also choose to stop having cervical cancer screening, unless the surgery was done as a treatment for cervical cancer or precancer. Women who have had a hysterectomy without removal of the cervix should continue to follow the guidelines above.
For more information about cervical cancer, contact the American Cancer Society at 1-800-ACS-2345 or log on to www.cancer.org.

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