by Jonathan Willms, DO, Chair of OB/GYN, Sun Life Family Health Center
Prior to the development of the Pap test, women commonly developed cervical cancer and died from it. In the 1940s, the Pap test was developed as a way to screen not only for cervical cancer, but also for the precancerous changes that could lead to cervical cancer. Now, significantly fewer women develop cervical cancer as a result of our ability to identify changes and target them so they cannot become cancerous.
The idea that we can identify risk factors for illnesses and changes that could lead to serious health problems is what makes a well-woman exam so important. A well-woman visit is a focused visit where we screen for potentially dangerous conditions and discuss important topics like nutrition and exercise. Although these are very important to work through together, they can often be overlooked when women come in for problem-focused visits. The well-woman visit allows time to discuss these topics.
The tests offered vary based on age and individual circumstances. Typically, testing for sexually transmitted infections is offered to woman of all ages. The Pap test begins at age 21 and occurs every three to five years when normal. Screening mammograms start between age 40 and 50 but sometimes earlier, depending on family history of breast cancer. Screening for colon cancer should begin by age 50. Women in their 60s are often offered a test to screen for bone density to identify those at risk for fractures.
All these tests are designed to detect changes that, if left alone, could turn into cancer. It is always better to catch precancerous changes or early stage cancer than diagnose cancer later in its course. These screening tests have all been shown to be effective in reducing the risk of developing cancer.
Unfortunately, we do not have good screening tests to detect many cancers in their earliest stages. I’m often asked about how we can screen for ovarian cancer. To date, there is no good screening test for ovarian cancer. We can, however, request a consultation with a genetic counselor when a woman’s family history suggests an underlying genetic condition like the BRCA 1 or 2 mutations.
In addition to screening for cancers, we discuss vaccines. One of the newer vaccines is the HPV vaccine, which covers women (and now men) against the most common strains of the human papilloma virus that causes genital warts and cancer. Not only is HPV associated with cervical cancer, but it also is linked to throat cancer, anal cancer and penile cancer in men. As more men and women are vaccinated, these cancers will become a thing of the past.
With a busy schedule, it may seem difficult to make time for things like a well-woman exam. It’s easy to think if you feel fine you don’t need to do it. However, if we’re able to detect a potentially serious medical condition early or before it becomes a problem, you’ll save yourself a lot of time in the end.