Cervical cancer is a malignant neoplasm arising from the cells and tissue in the cervix. Human papilloma virus (HPV) and human immunodeficiency virus (HIV) infections, smoking, and family history are risk factors.
Newlywed, 26-year-old Rebecca Jane Ryder (Becky), died in February, on Valentine’s Day, from the pernicious malady. When she was 24, in September 2010, Becky began experiencing abnormal bleeding and sought the advice of a physician.
Per the opinion of the general practitioner, and medical guidelines in the UK requiring a minimum age of 25, Becky was deemed too young to qualify for the simple exam that would have identified her cancer, a Pap test.
A Pap test (Papanicolaou test), also referred to as a Pap smear or smear test, is a diagnostic procedure and laboratory screening tool specifically performed in order to detect potentially precancerous and cancerous changes in the cells and tissue of the endocervical canal within the female reproductive system.
During a Pap, cells are scraped and collected from the outer opening of the cervix and the endocervix. These cells are then examined under a microscope for abnormalities, whether conventionally smeared directly onto the slide or using a liquid based cytology where the sample is put into a preservative at the time of collection and then later applied to the slide for examination.
After months of repeated visits to the same doctor with persistent, abnormal bleeding, Becky eventually sought another medical opinion, and was diagnosed with cancer from a biopsy. Despite courses of radiotherapy and chemotherapy the cancer metastasized (spread) and Becky ultimately succumbed to the terminal disease.
Now Becky’s widow, Paul Ryder, other loved ones, and the Mercedes Curnow Foundation for the early detection of cervical cancer are campaigning for a change in the legislation. They insist the minimum age requirement be lowered to 20 and doctors be permitted the right to have the test run based on their assessment of the symptoms. This particular cancer is rare in women Becky’s age, but not impossible, and should not have gone as long undiagnosed as it had.
Screening guidelines vary from country to country. Depending on the region, screening starts between 20 and 25, and is typically recommended every three to five years, as long as results are normal. In Canada, the Society of Obstetricians and Gynecologists and the Society of Canadian Colposcopists (SOGC) both take issue with the recommendation that women wait until age 25 to start cervical cancer screening, stating 25 is too late to begin Pap testing because precancerous and cancerous lesions may develop earlier in some women.
As part of the US Department of Health and Human Services, the Office of Women’s Health and the American Congress of Obstetricians and Gynecologists (ACOG) recommend women undergo a regular medical screening known as a Pap test. The exam can be administered by a physician or OBGYN, and should beginning at 21.
Some medical professionals suggest starting a regular exam shortly after a female becomes sexually active, others suggest waiting a few years after initial intercourse. Women whom have undergone menopause or partial hysterectomies (where the cervix is still present) also require regular screenings.
Typically, a Pap smear is done in part of receiving a prescription for oral birth control and should be scheduled in-between periods. A doctor may also perform routine pelvic and breast exams in the same visit.
Although initial stage cervical cancer can be asymptomatic, one of the earliest and most common symptoms is irregular vaginal bleeding. Moderate pain during intercourse or urination and abnormal discharge can also be warning signs to look for. Symptoms of advanced stage cervical cancer consist of loss of appetite, weight loss, fatigue, pelvic pain, back pain, leg pain, and heavy vaginal bleeding.
If you suspect your body is responding irregularly, noting the aforementioned symptoms and your doctor refuses to perform a Pap test, seek a second opinion. Reproductive cancers, especially when caught in the earliest of stages, have a high rate of recovery and survivability.
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