Regular Pap Tests, HPV Testing Vital for Prevention, Survival Rates
By Kimberly N. Alleyne
Reporting on Disparities
Approximately 4,200 women die from cervical cancer each year and research shows when African-American women are diagnosed they are twice as likely to die as their Caucasian peers.
Regular Pap smear testing is vital in preventing and diagnosing the disease, otherwise a woman will not know she has it.
That was Tamika Felder’s experience. If not for a doctor’s visit to investigate a boil under her arm, Felder would not have known that she had cervical cancer.
“After I graduated from college, I got a freelance gig with no benefits. I went without health insurance for several years, which meant I could not get annual testing. Then I landed a job with insurance benefits. Shortly after I got the job, I went to the emergency room because of a boil, and the doctor happened to ask me when I had my last Pap smear,” says Felder, who was diagnosed in 2001.
“Since I had not had a Pap smear, the emergency room doctor ordered one and that is how I was diagnosed, otherwise I would not be here,” Felder says.
Following the diagnosis Felder had a full or radical hysterectomy, chemotherapy and radiation—and at age 25, was left without the ability to bear children. She also became one of the estimated 11,967 women who are diagnosed with cervical cancer every year.
The treatment, Felder says, “was very difficult and I felt like I lost my chance for a happily ever after, but when I think about women who are no longer here, I feel like I cannot complain because they left families behind. So I am not here to tell my story.”
Known Cause Is HPV
Most cervical cancer cases are caused by the HPV virus or the human papilloma virus. HPV, a very common sexually transmitted infection, is transmitted by skin-to-skin contact.
Although Hispanic women have higher incidences of cervical cancer compared to other ethnicities, African-American women are 40 percent more likely to develop the disease, and tend to have lower five-year survival rates, too. These statistics are often attributed to lack of regular Pap smear screenings, but one study sponsored by the National Institute on Minority Health and Health Disparities suggests this is also because African-American women have a more difficult time ridding the HPV virus from their systems.
“There are no symptoms for HPV and early cervical cancer is often asymptomatic. So it’s important for women to get regular Pap smears,” says Dr. Estelle Whitney, a physician at Christiana Care Health Systems in Delaware.
Felder used her difficult experience as an opportunity to educate and encourage others about cervical cancer. In 2005, she formed Tamika and Friends, a nonprofit organization dedicated to raising awareness about cervical cancer and its link to HPV. January is cervical health awareness month, and Felder stresses that routine screenings such as the Pap smear test make cervical cancer one of the most preventable forms of cancer.
Dr. Peter Grossman, an Augusta, Ga.-based OB-GYN echoes that fact with other positive points about prevention and treatment.
“Well, there are four great things we know about cervical cancer: We have a precursor in cervical dysplasia (abnormal changes in the cells on the cervix surface); We know the cause, which is HPV; We have a great screening test with the Pap smear; and it takes a long time to develop, about 10 to 20 years from the initial exposure to HPV to the development of cervical cancer,” Grossman explains.
There are many different strains of HPV and Grossman says, “There are probably about 20 types associated with cancer of the genital tract, but 90 percent of them are associated with two particular strains, HPV 16 and HPV 18.”
According to the Centers for Disease Control and Prevention, vaccines [such as Gardisil® and Cervarix®] protect against the HPV types that most often cause cervical, vaginal, and vulvar cancers. Vaccines are recommended for 11- and 12-year-old girls, and also can be given to females ages 13–26 who did not get any or all of the shots when they were younger.
Risk factors include a compromised immune system, chlamydia, being overweight, multiple sexual partners, and unprotected sex. Smoking also compounds the risk of developing cervical cancer.
“Carcinogens embed themselves in cervical mucus, and women who smoke are less likely to clear the HPV virus,” Grossman says.
Number of sexual partners and the age when a woman first had intercourse are other potential risk factors Grossman says.
Not Always 100 Percent
Though routine testing is critical, “Pap smears are not 100 percent,” Grossman says. “There is a 20 to 30 percent chance of a false-negative where the test does not pick up a cancerous legion.”
In 2007, Quita Gibson was diagnosed with cervical cancer days after an annual Pap smear. “I didn’t understand why it was happening to me because I did what I was supposed to. I got a Pap smear every year,” Gibson says.
Fortunately Gibson was diagnosed at stage 1a1 which is early, and after discussing treatment options with her doctor, she elected to have a trachelectomy instead of a full hysterectomy. Even so, she was told her chances of conceiving a child, or carrying a baby to term, would be slim even with fertility drugs. But Gibson became pregnant about two years after being cancer free. Her son Avian will be four this August.
Like Felder, Gibson uses her experience to raise awareness. She founded Walk2Inspire, and hosts information events and walks in her community.
Felder beat the odds, too, and she got the happily-ever-after she feared cervical cancer had robbed her of. She is engaged to be married this spring. “I am engaged to a wonderful man and he has a daughter, so I’m going to be a step mom,” Felder says.
Felder admits she still has rough days sometimes, but finds strength in educating others about the importance of Pap smear testing.
“Preventing cervical cancer is the easy part. It’s one of the only cancers that we know the cause of…and it’s one of the ones we can start winning the war against,” Felder says.
American Cancer Society list of cervical cancer risk factorsYou have chlamydia, a common sexually transmitted disease.
- You eat few fruits and vegetables.
- You are overweight.
- You take oral contraceptives (birth control pills).
- You have had multiple full-term pregnancies.
- Your mother or sister had cervical cancer.
Your mother took a drug called diethylstilbestrol (DES) while pregnant with you.