As an OB/GYN here in San Diego, I know from my 20 years of experience how important preventive health is to a woman’s well-being. I’ve seen how regular screening and follow-up health care can detect serious health issues early on and save countless women’s lives.
While some aspects of personal health are beyond our immediate control, some of the most important ways to prevent unnecessary disease are available to us through comprehensive screening methods. For example, cervical cancer is one of the few diseases we can prevent through regular screening before it even becomes a problem. In collaboration with their OB/GYN, all women have the power to prevent cervical cancer.
Many people do not realize that this disease can be silent and deadly without adequate screening because cervical cancer does not always show symptoms until the disease has significantly progressed. It is preventable only through regular screening, which often allows us to detect abnormalities early when the disease is still highly treatable.
Current screening guidelines recommend Pap testing every three years for women ages 21-29 and Pap + HPV together (co-testing) every five years for women 30-65 years old. These tests give us the best possible chance to identify pre-cancers and treat them before they have a chance to become cancerous.
Both tests have a critical role to play because they look for different things. For example, HPV tests can detect the presence of the virus that causes cervical cancer while Pap tests look at cells and allow us to pick up serious cancer-related problems that could otherwise be missed.
I am concerned that any changes to screening guidelines that limit frequency and test options currently available could lead to women not visiting their doctors as often and result in missed cases of cervical cancer. At a time when cervical cancer rates are increasing in women under 50 years old, especially in younger women 25-29 years old, we cannot prioritize theoretical cost savings above proven lifesaving screening strategies.
The further we push out screenings, the less likely women will be able to keep regular appointments or keep track of when their screenings are due. This could lead to women also missing out of the opportunity to talk about and explore other issues relevant to their health — not just cervical cancer — including screening for pelvic infections that can be related to infertility or other important topics such as family planning. Waiting longer to screen for cervical cancer negatively affects other related areas of women’s health and, ultimately, is a disservice to women of any age or stage of life.
Additionally, some have recommended that the initial age of screening should be moved up from age 21 to 25 years old. I am deeply concerned that this would put women in harm’s way and cause us to miss worrisome cells before they progress into cancer. While it is unusual for us to see cases in this age range, it does happen. I have personally diagnosed patients with cervical cancer under the age of 25.
I can’t stand the thought of knowing what the potential outcomes would have been if these women were not screened until later in life. Even if the chances are rare, all women deserve a fighting chance. By raising the screening age, it is clear we would be gambling with young women’s lives.
We know the most effective way to prevent cervical cancer is through regular screening with the Pap and HPV tests. Although vaccines have done an exceptional job to help limit HPV infections, which are the primary cause of cervical cancer, they do not provide complete protection and uptake levels in the U.S. are insufficient to rely on vaccination alone. I encourage all women to stay vigilant and prioritize their annual Well Woman exams, including regular screening for cervical cancer. We cannot let down our guard.
I also want to reinforce to all my OB/GYN colleagues that we should continue to advocate for screening guidelines that provide the best opportunity to protect women. By working together, we can put women first and take the necessary steps to eradicate this unnecessary disease.
Dr. Nicole J. Nguyen is a board certified obstetrician/gynecologist and is a member of the American Board of Obstetrics and Gynecology.