Though enhancing your wardrobe with the latest Victoria’s Secret bras and panties sounds way more enticing (and is also necessary), staying up-to-date with health regulations regarding your feminine parts should take priority in your life right now, HC-ers. Since November of 2009, controversy has been stirred over the reversal and update regarding proper mammogram, breast self-exam and Pap test procedures. Though these recommendations are just strongly advised suggestions from major organizations to our physicians, many of us are still confused and concerned as to why they were edited at all. It is essential that you familiarize yourself with these new recommendations, become aware of why they changed, and continue to stay informed. That way you, along with your physician, can make the best decision about when the right time is for you to get tested or screened so you can stay in tip-top shape. Here is your need-to-know info:
Mammograms and Breast Self-Exams
Background
Breast cancer is the second leading cause of death for women in the United States. For years, organizations such as the American Cancer Society and the American College of Obstetrics and Gynecology advocated frequent mammogram screening and breast self-exams for women to help prevent or stop the cancer in its tracks. So, doctors and patients alike were stunned when the U.S. Preventative Services Task Force, with endorsement from the Institute of Medicine, changed their suggestions regarding screening and self-exams in November. However, as recent as early January 2010, organizations have come out combating these suggestions. Read on to discover both views:
The Old Recommendation
- Doctors should teach women to perform breast self-exams on themselves often
- Women should begin mammogram screening at age 40
The New Recommendations
Says who? U.S. Preventative Services Task Force, November 2009 (Read more here)
- Doctors should no longer teach women to learn and perform breast self-exams
- Women should begin regular screening at age 50 instead of 40
- There should be less screening for older women at risk for developing the cancer
REBUTTAL:
Says who? The American College of the Radiology and Society of Breast Imaging, January 2010
- Women at high-risk should begin mammogram screening by age 30 but not before age 25
- Mammograms should begin at 40 and should be done annually for women with an average risk of breast cancer
- Doctors should continue to teach patients breast self-exams
So, why the change?
Supporting the November Suggestions: Kay Dickersin, director of the U.S. Cochrane Center and the Center for Clinical Trials at the Johns Hopkins Bloomberg School of Public Health and breast cancer survivor told The Washington Post that screening every other year saves just as many lives but does less harm. She said that although not enough statistics support the idea that mammograms save lives, women have come to accept this idea as fact- hence, this feeling of drastic and sudden change. “Mammography doesn’t prevent breast cancer, it merely detects it,” she said. When asked about women in our age group (20-29 year-olds), Dickersin explained that the risk of breast cancer is very low. Screening only increased the likelihood of false positives, which is when a mammogram shows something that concerns a doctor but is not actually cancer. The doctor must then recommend additional mammograms or an MRI, both of which can trigger unnecessary biopsies, painful treatment and anxiety. Supporting the January Suggestions: Both organizations that released the joint recommendation stand firmly behind it as they “believe that the significant decrease in breast cancer mortality (nearly 30 percent since 1990) is largely due to earlier detection of breast cancer through mammogram screening.” The situation is similar for breast self-exams (interestingly enough, this site has yet to be updated with the new recommendations). The Baltimore Sun reported that “there is no evidence that breast self-exams save lives…a breast self-exam is associated with increased biopsies and imaging when women find something they think is suspicious.”
What does this mean for me?
HC readers, it is essential that you consult your physician to examine your family and medical history to determine whether or not you are in the high-risk group for breast cancer. Otherwise, practicing breast self-exams and receiving mammograms are personal choice. “I am still planning on getting screened and tested when the time is right,” said Hofstra University sophomore, Michelle Morgenstern. “Though I will consider the new suggestions, I’d rather be safe than sorry.” Dr. Nagi Khouri, Director of Breast Imaging at Johns Hopkins Avon Foundation Breast Cancer Center told The Baltimore Sun, “The more a woman is aware of herself, the more likely she maintains her health… In my view, telling the woman about being familiar with her breasts and how they feel is important. If anything feels different, show it to your doctor.”
Pap Smears
Background
Approximately 50 million Pap tests are performed each year in the United States. Pap smears screen women for changes in their cervical cells in order to indicate cervical cancer. According to the Centers for Disease Control, cervical cancer used to be the leading cause of cancer death for women in the U.S. However, the number of diagnoses and fatalities has decreased significantly over the past 40 years. Though the site attributes this positive news to regular Pap tests, the regulations for these tests have been edited as well.
The Old Recommendation
- Women should get their first test within 3 years of sexual intercourse or at age 18 and then annually after that.
The New Recommendation
Says who? The American Congress of Obstetricians and Gynecologists
- Women should wait until age 21 for their first test, and then receive pap smears every 2 years until they reach the age of 30. After 30, women should then have a test every three years.
So, why the change?
Similar to their reasoning behind changes in mammography and breast self-exams, experts say that the reduction in Pap tests will “minimize the risk of over-treating women with ‘normal’ cervical changes” and lower anxiety from false-positives and financial burdens. The reduction in unnecessary treatment will also help protect women from future pregnancy complications. “The driving force behind the change was the numerous studies that show women who are treated for cervical dysplasias are more likely to have a preterm birth,” said Dr. Alan G.Waxman, a professor at the University of New Mexico in Albuquerque who helped author the new guidelines. He said that this is not a radical chance in screening practice and has been in the works since the 1980s. Dr. John Curtin of The Cancer Institute at NYU Langone Medical Center in New York City said 70 percent of all college-aged sexually active people have contracted HPV (Human Papilloma Virus), which results in a high number of abnormal pap smears for women in our age group. The guidelines also show that only 0.1 percent of cervical cancer occurs in women under 21.
What does this mean for me?
If you’re concerned about the right time for you to receive a Pap test, consult your gynecologist immediately. It really depends on your age, family and sexual history. At this point, it is still clear that getting tested is essential. “Whether we screen everybody every two or three years isn’t probably not going to make a big difference I don’t think, just as long as they are getting screened,” said Curtin. Though the new guidelines are highly suggested, it may take a lot more convincing to stop women from getting screened and tested sooner rather than later, since no one wants to risk missing something that’s wrong with her body. Remember, HC readers – stay informed! Consult your doctor or gynecologist with questions, make the best decision for you, and stay safe. P.S. After your next appointment, splurge on the Body by Victoria Demi. You deserve it. To find out what you can do to help end breast and cervical cancer, check out Susan G. Komen for the Cure and the Partnership to End Cervical Cancer. Sources: Michelle Morgenstern, Hofstra University Sophomore http://www.washingtonpost.com/wp-dyn/content/article/2009/11/23/AR200911… http://www.baltimoresun.com/health/breastcancer/bal-md.mammogram17nov17,… http://www.associatedcontent.com/article/2405900/new_mammogram_advice_an… http://www.nydailynews.com/lifestyle/health/2009/11/18/2009-11-18_health… http://www.cdc.gov/cancer/cervical/statistics/index.htm http://www.associatedcontent.com/article/2412654/pap_smear_guidelines_an… http://www.associatedcontent.com/article/2412894/new_pap_smear_guideline… http://abcnews.go.com/GMA/HealthyLiving/guidelines-ditch-annual-pap-smea… http://www.cafemom.com/dailybuzz/healthy_living/9004/New_Mammogram_Guide…