Cancer of the uterine cervix accounts for 6% of all cancers in females in the United States which means the annual incidence rate is 15 per 100,000 women. An estimated 16,000 new cases of invasive cervical cancer will occur every year and will be responsible for 7,200 deaths in the U.S.A. All of the above figures are a sharp decline of the death rates and incidence rates of cancer of the cervix which can be attributed to the “pap smear test,’ which has been an outstanding contribution to medicine. The pap smear is a simple test that can be done in a doctors office and it is recommended that every woman should have a yearly pap smear starting at 18 years of age or when she gets sexually active. If she has been exposed to DES she should start having pap smears at age 14 or at the onset of menses. Since the cervix lends itself to easy accessibility, this is a safe and simple test and the cervical cancer can be diagnosed at a very early stage with a high incidence of cure.
This disease has a gradual rather than an explosive onset and hence it is easy to detect the disease in its pre-invasive stage, at which time it is in a reversible phase called cervical dysplasia and carcinoma in situ. The mean age of patients with carcinoma in situ of the cervix is 15 years younger than of patients with invasive cervical cancer. Hence, when screening pap smears are performed on women on an annual basis, the cancer can be detected and treated in its pre-invasive phase with much higher cure rates. If every woman is closely followed by pap smears, we can expect to eradicate most deaths due to cervical cancer by using the diagnostic and therapeutic techniques now available. Furthermore the pap test brings the patient to the gynecologists office where she may be appropriately screened for other gynecological malignancies and non-malignant processes.
The high risk factors for development of cervical cancer are early onset of regular sexual activity and continued exposure to multiple sexual partners. Low socioeconomic groups and youthful childbearing has been incriminated. It has also been associated with a generally transmitted virus like herpes virus type 2.
A typical patient with cervical cancer is between 45 and 55 years of age who married and delivered her first child before the age of 20. The first symptoms of cervical cancer are a thin, watery, blood tinged vaginal discharge that frequently goes unrecognized by the patient. The classical symptom is intermittent painless vaginal bleeding, often only spotting after intercourse or after douching, hence the keystone to early diagnosis and treatment of this dreadful cancer is in regular screening by an annual pap smear.
Article extracted from this publication >> January 18, 1985
