Mar
29
Cervical cancer is typically slow growing, and most cancers are found in women who have never been screened or who have not been screened in the past 5 years. Annual screening with PAP testing has been shown to lead to a very small increase in cancers prevented, but greatly increases the number of unnecessary procedures and treatments. Transient Human Papillomavirus (HPV) infections are common (80% of people) and associated low-grade pre-cancer is high. Most of these will lesions will regress within 1 to 2 years. So treating these patients does not provide a benefit large enough to outweigh the harms. The small fraction of lesions that do not regress will, on average, require many years to progress to cancer.
Consequently 2 weeks ago several national agencies* announced extended intervals for cervical cancer screening. For women 30 years and older, co-testing with PAP & Hi-Risk HPV every 5 years is preferred to PAP alone, but the later every 3 years is an acceptable strategy. In choosing to make co-testing the preferred strategy, these agencies focused on evidence from multiple randomized clinical studies showing that co-testing has improved accuracy compared with PAP alone. Specifically, co-testing has increased sensitivity (over 99%) for detecting advanced pre-cancer of the cervix. Because of this improved performance, co-testing can be used for screening at less frequent intervals than PAP alone. Recommendations for other age group are noted in this table:
| 1st PAP | 21 years old (and after intercourse initiated) |
| PAP Every 3 years | 20’s |
| PAP & HPV Every 5 years | > or equal to 30 years old |
| Stop Screening | > 65 years old |
| Hysterectomy |
Women with a history of advanced pre-cancer should continue annual screening for at least 20 years
It is very important to emphasize that the revised recommendations do not imply the end of the annual well woman visit. Counseling and education on topics varies by age:
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Adolescents and young women can benefit from counseling on healthy diet, risky behaviors, family planning, and—if they are sexually active—testing for sexually transmitted diseases. The focus for cervical cancer for this age group should be on primary prevention through HPV vaccination.
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Women of reproductive age will benefit from counseling and shared decision making on family planning, and treatment of excess menstrual bleeding.
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Women in the later reproductive years and perimenopausal women will benefit from counseling on the menopausal transition, osteoporosis prevention, and referral for mammography and colorectal cancer screening.
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Both women of reproductive age and postmenopausal women benefit from breast cancer screening and evaluation and treatment urinary incontinence and pelvic floor function.
This visit has always been more than just a “PAP smear,” and the decreased need for cervical screening actually constitutes a minor change to an important aspect of a woman’s health care.
Wishing You Good Health,
Women’s Health Specialists
2299 Mowry Avenue, Suite #3C
Fremont, CA 94538
510.796.7057
www.WomensHealthFremont.com
* U.S. Preventive Services Task Force and the American Cancer Society/American Society for Colposcopy and Cervical Pathology/American Society for Clinical Pathology
Mar
4
Surgery-Free Permanent Birth Control Should be 1st Choice for Women Who Have Completed Their Families
Filed Under Women's Health News
Surprisingly despite all the available methods of contraception, over half the pregnancies conceived in the United States are unplanned, this includes women over the age of 40 who falsely believe they cannot get pregnant. Even when used correctly birth control pills fail 5% and condoms 15%, per year. Are you comfortable with this risk of having an unplanned pregnancy? If you or someone you know has completed their family and is considering a form of permanent birth control, such as tubal ligation or a partner’s vasectomy, we would like to educate you about Non-Surgical Permanent Birth Control.
- Surgery-free—A simple procedure performed in your doctor’s office in less than 10 minutes
- Hormone-free—Works with your body to create a natural barrier to prevent pregnancy
- Anesthesia-free—No slowing down to recover, and return to normal activities in less than a day
- Worry-free—Since 2002 over half a million women and their doctors have trusted Essure® as the most effective permanent birth control
Hysteroscopic Sterilization is different from the traditional method of surgery called tubal ligation. There is no cutting into the body. Instead, your doctor inserts a thin scope through your body’s natural pathway of the vagina and into the uterus, where the openings to the fallopian tubes can be seen. Micro-inserts are placed into your fallopian tubes blocking them. Since most women only report mild cramps, you have the choice of having the procedure performed without general anesthesia. In fact, most women choose to have their procedure performed in the convenience of our office. Some women experience mild cramps afterwards and all return to their regular activities in less than a day. The doctors at Women’s Health Specialists were the first to perform Essure® and Adiana® in our community, and serve as instructors for other doctors desiring to learn this revolutionary office-based procedure.
During the first 3 months following Hysteroscopic Sterilization, your body and the micro-inserts work together to form a tissue barrier that permanently prevents sperm from reaching the egg. During this time, you will need to use another form of birth control. Then you will have a confirmation test to prove that your tubes are completely blocked and you can rely solely on Essure® or Adiana® for birth control. Here’s what one of our patient’s says about her experience with Essure.
Unlike birth control pills, patches, rings, injections, and some forms of IUDs, Hysteroscopic Sterilization does not contain hormones that interfere with your natural menstrual cycle. Your periods should continue in their natural state. Clinical studies have shown Essure® to be 99.85% effective at preventing an unplanned pregnancy, surpassing traditional tubal ligation, vasectomy, and IUDs. Consequently, it is not surprising that Hysteroscopic Sterilization is quickly becoming the treatment of choice for women seeking permanent birth control. Finally, these procedures are usually covered by your medical insurance. So if your family is complete schedule an appointment to talk to your doctor about more effective contraceptive options.
Wishing You Good Health,
Women’s Health Specialists
2299 Mowry Avenue, Suite #3C
Fremont, CA 94538
510.796.7057
www.WomensHealthFremont.com
PS: More information and videos click on this link: Surgery-Free Permanent Birth Control
