Let’s play “Good News, Bad News.”  We’ll start with the bad news.  In 2003, the American Cancer Society (ACS) estimates that there will be about 12,200 new cases of cervical cancer, and about 4,100 women will end up dying from it.  Now the good news.  According to the ACS, cervical cancer used to be one of the most common causes of cancer death in women in the United States.  But now, mostly due to the use of new screening tests, the number of deaths from cervical cancer has drastically reduced.  In fact, the ACS states that between 1955 and 1992 the number of deaths from cervical cancer decreased by 74 percent.  When detected early, cervical cancer can be treated.

Cervical cancer is cancer of the cervix, the opening to the lower portion of the uterus.  Cervical cancer typically takes time to develop.  Over the course of several years, cells may change from normal to pre-cancerous, and then to cancerous.

Like many other cancers, there seem to be certain risk factors that make a woman more susceptible to developing cervical cancer, including:

• Age: Most women are diagnosed between 50 and 55 years old, although it is a disease that is also seen in younger women.
• Women who begin having sex at a very early age (under 17 years of age) run a higher risk than normal risk of cervical cancer.
• Multiple sexual partners or frequent changes in sexual partners will increase a woman’s risk factors.
• Human Papillomavirus Infection (HPV): This large group of sexually transmitted viruses is the most important risk factor for cervical cancer. Women with HPV are at increased risk.
• Smoking: Women who smoke are nearly twice as likely to develop cervical cancer than non-smoking women.
• Human Immunodeficiency Virus Infection (HIV): HIV causes the immune system to become more susceptible, therefore increasing the risk for developing infections such as HPV, which could then lead to cervical cancer.
• Chlamydia Infection: This is a sexually transmitted bacteria that may increase a woman’s chance for getting cervical cancer.
• Diet: Diets low in fruits and vegetables have been linked to poor health, including cancers.
• Oral Contraceptives: There are studies that have shown a slight risk of developing cervical cancer for those women who have used birth control for more than five years.  Talk to your doctor about your individual risk and the right birth control for you.
• Low Socioeconomic Status: Women with low incomes typically do not receive proper healthcare and nutrition, putting themselves at a higher risk.
• Diethylstilbestrol (DES): DES is a hormonal drug given to women between 1940 and 1971. “DES Daughters” may be at increased risk for developing cervical cancer.
• Family History of Cervical Cancer: Women with a mother or sister with cervical cancer may be at a higher risk for developing the disease as well.

Remember, as soon as you are sexually active, you should begin having an annual GYN check-up that includes both a Pap smear and pelvic exam.  For while the Pap smear is your first, best defense against cervical cancer, the pelvic exam is an equally important part of your annual gynecological check-up.

Fortunately, cervical cancer is a treatable disease.  Since the most common type of cervical cancer starts with pre-cancerous changes, there are two ways to stop it from developing.  One is the prevention of the pre-cancers and the other is detecting and treating the pre-cancers before they turn into cancer.  The ACS recommends the following:

• Be sexually smart.  Avoid sex while young, limit your partners and always use a condom.  This helps to reduce your chance of getting HPV and other sexually transmitted diseases.
• Don’t smoke.
• Get a Pap test.  The ACS recommends that all women who are at least 18 years old or who are sexually active get a Pap test of the cervix done every year.

For more information on cervical cancer or your risks, talk to your doctor or contact the American Cancer Society.  And regardless of what you think your risks are, get an annual Pap test, eat right, don’t smoke and be sexually responsible. These are good ways to help ensure that when it comes to cervical cancer and playing the game of “Good News, Bad News,” you may get the good news you want to hear.

Dr. Rivera, an obstetrician/gynecologist who cares for hundreds of patients each year, is one of many quality physicians on staff at Des Peres Hospital.