Women who have a tubal ligation – the surgical tying or severing of fallopian tubes to prohibit pregnancy – have less frequent Pap smears, which puts them at an increased risk for cervical cancer, according to research recently released by a team that included Cara A. Mathews, MD, a gynecologic oncologist at the Program in Women's Oncology at Women & Infants Hospital of Rhode Island.
The findings were part of the National Cancer Institute-funded study "Study to Understand Cervical Cancer Endpoints and Determinants" being conducted when Dr. Mathews was a fellow at the University of Oklahoma. The results were published in late 2012 in the professional journal Gynecologic Oncology.
The objective, according to Dr. Mathews, was to investigate any connection between different types of contraception, screening frequency and cancer rates. Study participants were women who underwent a colposcopy after having an abnormal Pap test. The researchers used a questionnaire to identify factors associated with the cancer, including the frequency that the women went for Pap tests.
A Pap test checks for changes in the cells of a woman's cervix. The test can tell if the woman has an infection, abnormal cervical cells or cervical cancer, and has led to a major decline in the number of cervical cancer cases and deaths.
"Previously, we have advised women to have a Pap test every two years starting at age 21," Dr. Mathews explains. "Women over the age of 30 with three or more normal Pap tests were able to space screening intervals to every three years. And women over 65 without risk factors do not need to keep screening."
She and her colleagues, however, discovered that women who have had a tubal ligation were not as likely to have regular Pap tests.
"In all age groups, women with tubal ligation were more likely to have had no Pap screening in the previous five years compared to women using other forms of contraception," Dr. Mathews reveals.
The research publication came on the tail of new recommended Pap guidelines from the American College of Gynecology (ACOG), which state that women between 21 and 65 without risk factors should be screened every three years. Women ages 30 to 65 who want to extend the screening interval can go every five years.
"In issuing the new guidelines, ACOG stressed the importance of emphasizing well visits and screenings in women, including the Pap test, to promote health and prevent cancer," Dr. Mathews concludes.
For more information about personal testing, women can call their gynecologist or family care practitioner. For a list of physicians accepting new patients, they can call Women & Infants' Physician Referral Line at 1-800-921-9299. Women diagnosed with cervical cancer or who have had an abnormal Pap test can be referred to the Program in Women's Oncology at 401-453-7520.
About Women & Infants Hospital
Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation's leading specialty hospitals for women and newborns. The primary teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology and newborn pediatrics, as well as a number of specialized programs in women's medicine, Women & Infants is the eighth largest stand-alone obstetrical service in the country with nearly 8,400 deliveries per year. In 2009, Women & Infants opened the country's largest, single-family room neonatal intensive care unit.
New England's premier hospital for women and newborns, Women & Infants and Brown offer fellowship programs in gynecologic oncology, maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, neonatal-perinatal medicine, pediatric and perinatal pathology, gynecologic pathology and cytopathology, and reproductive endocrinology and infertility. It is home to the nation's only mother-baby perinatal psychiatric partial hospital, as well as the nation's only fellowship program in obstetric medicine.
Women & Infants has been designated as a Breast Center of Excellence from the American College of Radiography; a Center for In Vitro Maturation Excellence by SAGE In Vitro Fertilization; a Center of Biomedical Research Excellence by the National Institutes of Health; and a Neonatal Resource Services Center of Excellence. It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology and newborn pediatrics in the nation, and is a member of the National Cancer Institute's Gynecologic Oncology Group and the National Institutes of Health's Pelvic Floor Disorders Network.
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