Recommitting to Cervical Cancer Prevention after COVID-19
Concerning recent reports have demonstrated that the COVID-19 pandemic caused the rate at which women get tested for cervical cancer to decrease. The Centers for Disease Control and Prevention (CDC) says this "sharp decline" could lead to "poor health consequences" and "an increase in cancer disparities among women already experiencing health inequities."[i] Adding to this concern is the fact that cervical cancer testing compliance in the US had started to falter even before the pandemic began.[ii]
I have seen this troubling trend first-hand at my practice, where many women delayed their regular appointments and tests for diseases like cervical cancer, often because they were busy taking care of others in their family and had no time left to prioritize their own health.
Patients are clearly not to blame for missed appointments during the pandemic, but regular testing and a strong patient/physician relationship are critical to get back on track and protect women's health.
In the case of cervical cancer, for example, the Pap and HPV tests can prevent disease.[iii] Additionally, it's important to recognize that cervical cancer screening is really a precancer screening that can detect the presence of pre-cancerous cells.[iv] It is due in part to the success of regular testing and the ability to catch disease early that the rate of cervical cancer in the U.S. has dropped more than 70% since the Pap test was introduced in 1941.[v]
Yet in Illinois, more than 20 percent of women ages 21-65 still say they are not up-to-date on cervical cancer screening.[vi] This is particularly concerning when you consider that among the five main gynecological cancers - cervical, ovarian uterine, vaginal and vulvar - cervical is the only one that can be prevented through screening.[vii]
The Pap test remains a critical tool to prevent disease, and that's not going to change. But today, we know that the Pap test and the human papillomavirus (HPV) test used together - "co-testing" - is considered the gold standard. The largest ever retrospective study of cervical cancer screening strategies demonstrates this, showing that 95 percent of cervical cancers were detected by testing with Pap and HPV together.[viii] Meanwhile, studies have also shown that an HPV test alone will miss one in five cervical cancers if performed without the Pap test[ix] -- furthering bolstering the case for co-testing.
Based on this evidence, guidelines from the American College of Obstetricians and Gynecologists (ACOG) and most other mainstream professional organizations recommend use of the Pap test alone every three years for women 21 to 29 years of age and co-testing with the Pap test and HPV every five years for women starting at 30 years old.[x] This is the prevention strategy I follow to protect my patients from unnecessary disease.
As women begin to come back for their annual visits after the pandemic, I remain committed to helping them understand the importance of cervical cancer screening and the crucial role this testing plays in protecting their holistic health. True progress will come from working together, patient and physician, to encourage women to put their health first and pursue the wellbeing they deserve.
Neelam Gandhi, M.D. is a board certified OB/GYN in South Barrington, Ill.
About Dr. Gandhi
Dr. Neelam Gandhi, MD is an Obstetrics and Gynecology Specialist in South Barrington, Illinois and has over 24 years of experience in the medical field. She graduated from Howard University, College of Medicine medical school in 1998. She has been affiliated with medical facilities such as Northwestern Medicine McHenry Hospital and Northwestern Medicine Huntley Hospital. Dr. Gandhi opened her own private practice in 2003. She is on staff at Advocate Good Shepherd Hospital in Barrington and St. Alexius Hospital in Hoffman Estates.
As a doctor, woman, and mom herself, Dr. Gandhi understands all the important moments in one's life. She strongly believes that empathy is the key for a safe and respectful lifelong doctor-patient relationship.
Neelam Ramesh Gandhi, MD
33 W S Higgins Rd Ste 800
South Barrington IL 60010