As more people get vaccinated against COVID-19, I’m hoping fewer people continue to delay much-needed care for ongoing medical issues.
Research has shown that more than four in 10 adults in the United States have delayed or avoided medical care because of the pandemic. Just as importantly, however, I’m hoping people also pursue preventive measures that sometimes, even under the best of circumstances, fall through the cracks.
In the past year, I’ve become concerned that those cracks have deepened in my profession as women delay their well-woman appointments and those critical cancer screenings that come with it.
Cancer screening is often part of the exam when you come to the gynecologist.
During the annual visit, this includes a pelvic exam and an examination of breast health. It sometimes includes a Pap test to screen for cervical cancer, which is among the most preventable and, when diagnosed early, treatable of cancers.
Here in South Carolina, where cancer more generally remains the second leading cause of death, the rate of cervical cancer is higher than the national average. And it is much higher for black and Hispanic women.
Every year, about 65 of our fellow South Carolinians — mothers, daughters, sisters, aunts and friends — die of cervical cancer. Members of the South Carolina Cancer Alliance have set a goal to increase the percentage of women age 21 to 65 who have received a Pap test in the previous three years. We’d like to increase it from 82.4% to at least 90% by Dec. 31.
The Pap test, which detects cervical disease on the cervix, is a critical component of cancer screening. When it is administered together with the human papillomavirus (HPV) test, which screens for the presence of the virus, women have the best chance for the earliest and most accurate detection. And even better for the patient, this co-testing involves only one procedure.
Like many cancers, the earlier cervical cancer is diagnosed, the more likely it is that treatment will be effective. Unfortunately, in all regions of South Carolina, more than half of all invasive cervical cancers are diagnosed at an advanced stage.
The U.S. Preventive Services Task Force, which is funded by the Department of Health and Human Services, notes that most cases of cervical cancer occur among women who have not been adequately screened. And yet, the task force reports that more than 8 million women ages 21 to 65 have not been screened in the past five years.
Despite all these hard facts, testing remains a very personal matter. It’s one whose variables should be discussed on a case-by-case basis between a woman and her doctor so they can decide on the best plan.
While there are guidelines from professional organizations and other entities about who should be tested — and when, how often and with what test or combination of tests — physicians consider many circumstances, including a patient’s age, underlying conditions and sexual history.
With the ebbing of the COVID-19 pandemic, now is the time for women to follow through on preventive measures such as cervical cancer screening that they may have postponed. The annual exam only works well if women actually have it.
Let’s work together to reduce the number of women diagnosed, as well as the number of women who die from cervical cancer in South Carolina. Get cervical co-tested. It saves lives.
Dr. Paula Orr is a board-certified gynecologist at the Charleston Women’s Wellness Center and has more than 27 years of experience in the medical field.
