What Long Island Women Should Know About Cervical Cancer by Patricia Wasserman, MD, FCAP 

Cervical cancer is one of the most common female cancers with an estimated 490,000 cases reported annually worldwide. Although cervical cancer is usually curable if detected early, the American Cancer Society estimates that nearly 10,000 women in the U.S. will be diagnosed and about 3,700 will die of the disease each year.

     Today in the U.S., more than 50 million women receive an annual Pap test to screen for cervical cancer. Great strides have been made in cervical cancer screening over the past century, beginning with the development of the "Pap smear" test by Dr. George Papanicolaou in the 1920's.

     The Pap smear, which was widely adopted in the 1940's, was a procedure in which sample cells from the cervix were collected and smeared onto a glass slide for careful review in order to detect cancerous and pre-cancerous cells. While the Pap smear reduced mortality from cervical cancer in the U.S. by approximately 70 percent, it was found to have limitations, not the least of which was a 20-40 percent "false negative" rate, meaning a sample is interpreted as normal when in fact, pre-cancerous or cancerous cells exist.

     Improvements on the Pap smear occurred in the late 1980's, when researchers in the field of cervical cancer screening learned that to automate the processing of traditional Pap slides, it was necessary to change the way in which Pap slides were prepared. In 1996, the Food and Drug Administration (FDA) approved the ThinPrep Pap Test as an alternative to the conventional Pap smear.

     The ThinPrep Pap Test is a liquid-based Pap test that uses a fluid transport medium to prepare a slide that is clear, easy-to-read and free of obscuring blood, mucus and non-diagnostic debris. "Reflex" screening for HPV, Chlamydia and Gonorrhea can be done out of the same sample, saving patient's time, repeat office visits and unnecessary worry. Today, more than 87 percent of Pap tests in the U.S. are performed with the ThinPrep Pap Test.

     In a continued effort to improve and expedite the review of Pap test slides, the FDA cleared the ThinPrep Imaging System in 2003 to make it easier for cervical cancer lesions and other abnormalities to be detected. With approximately one third of false negative Pap results being due to abnormal cells being missed or misclassified, the ThinPrep Imaging System is an interactive computer system that assists cytotechnologists and pathologists in the primary screening and diagnosis of ThinPrep Pap Test slides.

     Long Island Jewish (LIJ) Medical Center in New Hyde Park recently implemented the ThinPrep Imaging System to improve diagnostic accuracy, which can lead to earlier detection of precancerous changes for local women.

     Although manual screening by cytotechnologists in labs is challenging and tedious, it remains widely-recognized that technological screening advancements ultimately rely on human interpretation of the slides. The ThinPrep Imaging System relies on an efficient combination of technology and human interpretation to review lab samples.

     It's also the first system of its kind to scan every cell and cell cluster, identifying areas of interest for further review by the cytotechnologist. This allows the cytotechnologist to better focus his or her interpretive skills on these defined areas to identify potentially life-threatening conditions for patients.

     In June 2006, the FDA approved the first vaccine to protect against Human Papillomavirus (HPV), a common sexually transmitted virus that causes cervical cancer. While this advance in women's health is exciting, it's important to understand that the vaccine won't replace or eliminate a woman's annual Pap test which remains the gold standard for cervical cancer prevention.

     The vaccine guards against four types of HPV, which are responsible for approximately 70 percent of all cervical cancers. The duration of protection provided by the vaccine is unknown. Therefore, early detection through an annual Pap test remains imperative for all women-vaccinated or not. Additionally, HPV does not always lead to cervical cancer. Approximately 80 percent of sexually active people will be infected with HPV at some point in their life, and the infection goes away on its own 90 percent of the time.

     Therefore, all women must continue to visit their physician for their annual exam, receive regular Pap tests and educate themselves to ensure they are receiving the most effective test available. With the implementation of the ThinPrep Imaging System at LIJ Medical Center, local women can take advantage of the best cervical cancer screening available and ensure they are doing what they can to protect themselves from this devastating disease.

     To learn more about advancements in cervical cancer screening, please contact Dr. Patricia Wasserman at LIJ Medical Center or visit www.thinprep.com. Patricia Wasserman, MD, FCAP, is the Chief of Cytopathology at Long Island Jewish (LIJ) Medical Center in New Hyde Park and Assistant Professor of Pathology at Albert Einstein College of Medicine in the Bronx. LIJ Medical Center is a 452-bed adult-care hospital that provides comprehensive inpatient and outpatient care, and advanced diagnostic and treatment technologies in all specialty areas, including cardiovascular, cancer, obstetrics and gynecology, neurology and orthopedics.