In our May article we were discussing how much luck, or bad luck, is involved in developing a cancer. Apart from those more general considerations, it is known that certain viral infections can beat the path for cancer. An estimated 15% of all cancers can be explained this way.
One of those is HPV – Human Papilloma Virus. It is transmitted by having sex with an infected partner and can cause genital warts, which are embarrassing and a nuisance, but will normally disappear after some time even without treatment.
It’s more serious sibling though is cervical dysplasia or cervical cancer which is still a frequent cause of premature death. For many years the precursor of cancer has been detected by taking the very often, very much dreaded, smear-test: with a brush, a sample would be taken from the cervix and examined under a microscope for cancer-cells.
Nowadays, there is a new technique which uses a morning-urine sample to detect traces of HPV-DNA.
It seems most women would prefer handing in a self-collected urine sample as compared to undergoing a vaginal speculum examination.
This new diagnostic tool is entering national screening programs and should soon be available in Spain.
At this moment, it is recommended for average-risk women (no first grade relatives with cervical cancer), to have no screening at all before the age of 21. Between 21 and 30 years of age there is a high rate of HPV infection, but as well, a high rate of spontaneous clearing of that infection and therefore a smear test every three years is the best option.
After 30 years of age, smear-test and HPV-test are recommended once every five years. After the age of 65 and with two normal smear-tests and a normal HPV-test in the last 10 years, screening can stop altogether.
Similar to breast cancer screening (see the January 2015 article), one gets increasingly aware of the harm caused by too-frequent screening, which includes unnecessary diagnostic biopsies and surgical procedures, as well as expenses and anxiety.
These less frequent screening recommendations will be difficult to accept for many women and doctors alike, but they are supported by all medical associations from gynecologists to oncologists.
Less can be more. Activism can be blind (and harmful) and trust is difficult if anxiety lingers in the corner.
But listen to (and look at) Goya: The sleep of reason creates monsters. Good medical information and reasoning, as obtained from your preferred G.P., will fight monsters off. And even though modern diagnostic procedures may drive physicians into unemployment, they will have more time for listening to their patients.
(News/Medical: Cervical Cancer and Screening)