Pap smears – fun for everyone, right? In the 12 years that I’ve been having regular pap smears, not once have I had one that was uneventful.
From freezing cold metal speculums, to the screws not being done up tightly enough when it was fitted, thereby pinching the inside of my vagina mid-test, to scary test results needing further investigation (can anyone think of a more invitingly-named medical procedure than a “punch biopsy”?), I’ve had it all.
Who hasn’t had an insensitive doctor who didn’t use enough lubricant (the same ones who tell you a punch biopsy “can’t hurt because there’s no pain receptors there”), or a version of one of my pap smears, where the female nurse admitted to me, mid-test, that she’s “glad we now use disposable speculums, as the reusable ones make me gag when we have to autoclave them.” Guess I’ll have to try harder not to mess them up, then.
And what is it they’re for again? Oh, that’s right, they’re to screen for cervical cancer. And while Pap smears may not be a barrel of laffs, putting them off could have dire consequences.
January is Cervical Cancer Awareness Month, and although researchers are closer than ever to finding a cure for the pre-cancerous condition that directly leads to cervical cancer, medical professionals are still concerned at the lack of knowledge many women have about the disease.
Cervical cancer is the second most common cancer — and the third leading cause of cancer deaths — in women worldwide. More than 10,000 women in the United States develop cervical cancer each year and nearly 4,000 die from the disease. The American Cancer Society reports that between 60 and 80 percent of American women with newly diagnosed invasive cervical cancer either have not had a Pap smear in the past five years, or have never had one. Groups with the lowest screening rates include the uninsured, older women, ethnic minorities (especially Latinas, African Americans and Asian Americans), and poor women, particularly those in rural areas.
But there’s now a new weapon in the fight against cervical cancer, and it should be available as early as this year. New vaccines currently in late-stage clinical development work by targeting two cancer-causing types of the human papilloma virus (HPV 16 and 18), which account for more than 70 percent of all cervical cancers. HPV is a virus that is transmitted through sexual contact.
Even though human papilloma virus is the most common sexually transmitted infection, infecting up to 80 percent of the American population at some point in their lives by the time they turn 50, many people have never heard of it. The spread of HPV is hard to prevent because it can be transmitted simply through skin contact in affected areas, and condoms only offer limited protection.
Two separate but similar vaccines for human papilloma virus have been developed. In clinical tests both versions have proven to be extraordinarily effective. Researchers have proven that the new vaccine blocks contraction of the two most dangerous type of HPV (16 and 18) in every woman who received the inoculation. Medical researchers believe the vaccine, if administered routinely, could virtually eradicate the second most deadly type of cancer in women.
GlaxoSmithKline and Merck, the two companies developing the vaccines, have both shown research data that confirms the vaccines are safe to use in children as young as 10. Interestingly, the data also shows that when administered to girls aged 10 to 14, the subjects produced twice the amount of HPV antibodies as test subjects aged15 to 25, meaning the vaccine is most effective when administered at a younger age.
But the proposed age range of the vaccine recipients has raised a few eyebrows, given the sexual nature of the transmission of HPV. Conservative groups have raised concerns that the vaccination of children against sexually transmitted diseases is an open invitation to be promiscuous. As far-fetched as this argument sounds, (when I got my rubella vaccination at age 13 I sure wasn’t thinking, “Great, now I can go out and screw around without the fear of having a deaf baby!”), groups like the Family Research Council and Abstinence Clearinghouse are suggesting that vaccinating young girls would send them a message that premarital sex is acceptable.
It is the political action of moral rights groups like these that saw the Food and Drug Administration’s rejection of an application to sell over-the-counter emergency contraceptives, and similar action could stall the mass production and sale of these new vaccines.
However, the Council for Disease Control and Prevention currently recommends children aged 10 to 15 receive vaccination against Hepatitis B, an infection usually transmitted sexually, and as both the HPV and Hepatitis B vaccines are administered in three doses over six months, they could be administered simultaneously.
Another issue, separate to the approval of the HPV vaccine, is one of government funding to make it more affordable for recipients. If conservative groups lobby successfully against government funding of a drug they’re promoting as leading to promiscuous behavior, the neediest recipients of the vaccine, including the uninsured and the poor, may miss out.
While the HPV vaccine is not yet available on the market, the best screening tool for cervical cancer, the pap smear, is. Cervical cancer is preventable, and almost 100 per cent curable if detected early. Enough of the procrastinating: (I know I’ve been putting it off) January, Cervical Cancer Awareness month, is the time to book appointments for ourselves, and to remind our girlfriends and mothers, to get back in those stirrups, and grin and bear it. Call your doctor, or ask for the number of a good gynecologist from a friend or colleague, and take an active role in cancer prevention. Hmmm, I wonder if they’ll let me bring my microwave heat bag to warm the speculum first?
