By Martha A. Simpson, D.O., M.B.A.
Assistant Professor of Family Medicine
Ohio University College of Osteopathic Medicine

[Editor’s Note to Ohio Newspapers: Since September is Women’s Health Month in the Buckeye State, this week’s column will address two of the most important steps a woman can take to improve her chances of good health and a long life.]

WHAT EVERY WOMAN SHOULD KNOW: PAP SMEARS AND MAMMOGRAMS SAVE LIVES

Question: My older sister was operated on for cervical cancer. Even though the doctor says she’ll be okay because it was caught early, I’m starting to worry about my own health. As a healthy 25-year-old woman, I’ve never thought much about seeing the doctor. What health matters should I be concerned about?
Answer: It’s clear that you have already learned an important lesson from your sister’s experience –- early detection is a key to successful cancer treatment. For this you should be commended. Your question really encompasses two kinds of issues –- health problems that are exclusive to women (those related to the female reproductive organs) and those that afflict both sexes, some of which are more common in women and others in men. Today, I’ll focus on two health problems that are almost exclusively female concerns –- breast and cervical cancer.

While cancer of all kinds is the second most common cause of death for women, this scourge originates in the breast far more often than in any other organ. There are about 180,000 women with this dreaded disease every year! You might be surprised to learn that men, too, can get breast cancer, but it is very uncommon.

Medicine hasn’t identified a way to prevent breast cancer, but early detection can dramatically improve the chances of your survival. Even though you are only 25, I urge you to start regular monthly breast self-examinations (BSE) and report any questionable findings to your doctor immediately. Your family physician or gynecologist can teach you how to do a BSE.

I’m sure most of my female readers know that a yearly breast examination by a physician and yearly mammograms are advised after age 50. But how many of you do these simple tests? A national survey a few years ago showed only 41 percent do. This is disconcerting because an annual physical exam with mammograms reduces the risk of dying from breast cancer by 25-30 percent.

Some women avoid mammograms because of a mistaken belief that they have little risk of developing the disease because no one in their family has had it. Unfortunately, three out of four women who develop breast cancer have no family history or other risk factors for the disease. On the other hand, a woman with a family history of breast cancer may need to begin yearly physicals and mammograms at an earlier age.

The other common disease I want to discuss is the one your sister had –- cervical cancer. The widespread use of pap smears has created a success story of sorts. In 1940, cervical cancer was the most common cause of cancer death in women. Today it barely makes the top ten. Despite this favorable trend, we health-care providers need to do better. Cervical cancer is generally a slow growing disease, and yearly examinations usually identify the condition in its early -- curable -- stage. Of those women who are diagnosed with cervical cancer, however, about half have never had a pap smear.
Pap smear screening for cervical cancer is easily done and relatively inexpensive. Those who are poor, elderly, uninsured, belong to an ethnic minority, or live in a rural area are less likely to get a regular pap smear. Therefore, these groups have more women who die from cervical cancer.

Every woman should have a pap smear when she begins having sexual intercourse or reaches the age of 20. This practice should continue every one to two years thereafter. There are other conditions that make more frequent pap smears advisable.

Please be sure to get a pap smear, and ask your doctor when you should come back for your next exam. If you have a friend or family member in one of the high risk groups I listed above, please ask them if they’ve had a pap smear lately.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnosis and recommend treatment for any medical conditions. Past columns are available online at http://www.FamilyMedicineNews.org.