Ceervical Cancer Case Study

Harms related to cervical cancer screening with a Pap Smear are related to abnormal results. Abnormal results of a Pap Smear can cause short-term psychological harms that include anxiety and distress (USPSTF, 2016a). Abnormal results can also lead to further or more frequent testing (USPSTF, 2016a). Diagnostic procedure harms include vaginal bleeding, pain, and infection (USPSTF, 2016a). Harms of cervical treatment primarily include risks related to “adverse pregnancy outcomes” which include preterm delivery, low birthweight, and perinatal death (USPSTF, 2016a). Harms related to cervical treatment are also associated with false-positives (USPSTF, 2016a). Thus, overtreatment can be detrimental to the patient (USPSTF, 2016a).

If the Pap smear test results reveal abnormal cell changes, a physician will recommend for a women to undergo a colposcopy. A colposcopy is a procedure where a physician washes the cervix with a diluted vinegar solution and uses a microscope-like tool known as a colposcope to have a magnified view of the surface of the vagina and cervix. If the physician sees any abnormal areas, such as lesions on the cervix, then tissue samples are taken for examination under a microscope. Other than the Pap smear, a pelvic exam may be performed. In a pelvic exam, the vagina, along with adjacent organs, is examined visually and manually. A speculum, and instrument that separates tissue, is inserted into the vagina for visual examination. After, the organs are felt with the fingers by inserting one hand in the vagina, and putting the other hand on the abdomen to feel for any abnormalities. If invasive cervical cancer is suspected, or if the colposcopy and the Pap smear have different results, then other tests may be conducted. One test that may be performed is a cone biopsy. In a cone biopsy, a larger, cone shaped sample of cervical tissue is taken and examined for cancer cells. Another test that may be performed is endocervical curettage. During this procedure, the lining of the cervix is scraped and examined for cancer cells. Once a diagnosis of cervical cancer is made, then the

Cervical Cancer Early Detection Program Journal of Women’s Health 20(10):1479-84 doi: 10.1089/jwh.2010.2530. Epub 2011 Jul 20

Almost all cervical carcinomas are caused by Human papillomavirus (HPV). Cervical cancer can be a life-threating disease. However, over recent years the occurrence of cervical cancer has declined as well as the chance of dying from it. A huge contributing factor to this decline is the importance of a regular pap smear. A pap smear can find cervical pre-cancer before it turns into cancer. Recently, a vaccine for HPV, has been on the market, which provides close to a 100% protection against pre-cancer and general warts. HPV and cervical cancer are two disease that are closely related. However, each disease effects not only similar populations, but also different populations, as well as having its own signs and symptoms, detection procedures,

The symptoms of cervical cancer are not always obvious thus the introduction of NHS cervical screening programme. The aim of the NHS Cervical Screening Programme is prevent the number women who die from cervical cancer each year due to not having early diagnoses. Since the introduction of the programme, a report was done between the NHS Cervical Screening Programme and Trent Cancer Registry it found that “Incidence and mortality rates in England have fallen considerably over the past 20 years. During this period, incidence rates decreased by over a third and mortality rates reduced by 60%. Survival, following a diagnosis of cervical cancer has improved in England since the 1980’s from the 83% to 88%”. (NHS, 2012, pp. P10-11).

If cervical cancer is found treatment will be dependent on the type of cervical cancer and the stage of the cancer. There is a surgical treatment which is where the cancerous tissue is removed, such as by a hysterectomy, Chemotherapy to slow down or stop the growth of cancer cells. Lastly, there is radiation treatment to kill the cells and control the spreading of the cancer. These options can be used independently or altogether. There are constantly new treatments becoming available and sometimes a patient can be able to become part of this new treatment through clinical trials. The second test which can be done concurrently with the Pap test is the HPV test.

According to the Centers for Disease Control and Prevention (CDC), Human papillomavirus (HPV) infects roughly 20 million individuals in the United States with 6.1 million new cases each year. There is no cure for HPV, only treatment for associated health problems. There are more than 30 strains of HPV that affect more than half of sexually active individuals in their lifetime. Public health risks involve several types of HPV leading to precancerous lesions and causing 70% of cervical cancer. Cervical cancer, the second most common cancer, affects many women globally. In the United States, nearly 10,000 women are diagnosed with cervical cancer annually and 3,700 of those women die. It has been reported by American Cancer Society that with early

In US cervical cancer is ranked 13th most common cancer in women and 4th among women between 15 to 44 years.

Did you know there is more of a link between cervical cancer and HPV than smoking and lung cancer? Cervical cancer is currently the fourth most common cancer in women and the second leading cause of death from cancer in women. Along with those statistics, human papillomavirus is the most common sexually transmitted viral disease amongst men and women worldwide. The prevalence of women having a strain of HPV that ultimately leads to or increases the chance of cervical cancer is highly relatable. What is pathophysiology, signs, symptoms, prevention, and treatments of this ailment? You might ask will be covered in the next few pages of this paper.

Screening programs utilize diagnostic tests on individuals who are asymptomatic of certain diseases and the intent of diagnostic tests are used to establish the probability of having a certain disease (New York State, Department of Health (n.d.). As a provider, the fundamental intention of screenings is to reduce morbidity and mortality; however, providers must also understand the potential affect on individuals if results reveal false-positives and false-negatives (Gates, 2001). Therefore, diagnostic accuracy is critical and making sure quality of screenings is important in that the tests are sensitive enough to detect disease during the period in individual who do not have symptoms of a particular disease and specific enough to lessen the incidence of false positives (Gates, 2014). Screening the female population with Pap (Papanicolaou) smears for cervical cancer is considered a sensitive test (Lalkhen & McCluskey, 2008).

Among the 12, 200 new cases of cervical cancer ninety-percent of them are caused or attributed to HPV.

HPV screening is accomplished by way of cervical cancer screening. In 2014, the fda approved the first hpv test for primary screening in females ages 25 to 65, however, current national guidelines are for the use of hpv testing to detect oncogenic serotypes, in the presence of an abnormal Pap test CITE 6 3. The current screening recommendations of the American Cancer Society, the American Society for Colposcopy and Cervical Pathology, the American Society for Clinical Pathology, the American Congress of Obstetricians and Gynecologists as well as the U.S. Preventative Task force do not recommend cervical cancer screening for women under the age of 21. Between the ages of 21 and 29, the recommendation is for screening with a

Among the many arguments for mandatory HPV vaccination, the foremost is that it is an important medical achievement and a major public health milestone. This vaccine has proven to be one-hundred percent effective in preventing the 4 HPV strains that are responsible for seventy percent of cervical cancers and ninety percent of genital warts. In addition, no serious side effects have been identified. Because this vaccine is a preventive measure, administration before onset of sexual activity is ideal; however, even females who have been sexually active can still benefit from this vaccination (Perkins et al., 2010). Nationally and internationally, the HPV vaccine will significantly reduce disease burden by reducing monetary and psychological costs of invasive procedures that remove precancerous and cancerous lesions. By combining vaccination with routine Pap smear screening, these public health efforts have the remarkable opportunity to eradicate cervical cancer (Ramet et al., 2011).

Visual inspection with acetic acid (VIA) is a simple, inexpensive test, with moderate sensitivity and specificity for screening that can be combined with simple treatment procedures for early cervical lesions (59). Visual inspectionis direct visualization of the cervix after application of a solution of either acetic acid 3–5% (VIA) or Lugol’s iodine (VILI). A result is obtained immediately and treatment can be performed at the same setting. In visual inspection with acetic acid (VIA), CIN lesions will turn white for a few minutes after application of acetic acid. The effect of acetic acid depends on the amount of nuclear proteins, and cytokeratins present in the cervical epithelium, which increases in CIN. (60) Scaling up and inclusion of VIA-based

In the United States, it is one of the eight-most common cancer of women. According to researches, the data shows that Hispanic women are significantly more likely to be diagnosed with cervical cancer than the general population and their median age at diagnosis is 48. In 1998, about 12,800 women were diagnosed in the US and about 4,800 died. Among cancers of the female reproductive tract, it is less common than endometrial cancer and ovarian cancer. The rates of new cases in the United States was 7 per 100,000 women in 2004. Cervical cancer deaths decreased by approximately 74% in the