OWATONNA, Minn. — Cervical cancer is one of the most common types of cancer in women, with the American Cancer Society estimating that almost 14,000 new cases of invasive cervical cancer will be diagnosed in 2023. Of those cases, over 4,000 women will likely die from the disease.

Fortunately, precancerous cervical lesions are easy to diagnose with a Pap test, or cervical cancer screening, leading to better outcomes for treatment. But for many women, finding the time for a Pap test and other preventive health screenings can be a challenge.

Mayo Clinic Health System in Southeast Minnesota hopes to change that. Through the Saturday Pap Clinic, Family Medicine and Community Internal Medicine patients in Cannon Falls, Lake City, Owatonna and Red Wing can take advantage of convenient Saturday appointment times for cervical cancer screening.

The Saturday Pap Clinic, which launched through Mayo Clinic Primary Care in Rochester and Kasson in late 2021, has helped make cervical cancer screening more accessible by offering flexibility for women who might otherwise struggle with access to preventive care. Blood pressure checks, colon cancer screenings, breast cancer screenings and overdue labs also can be reviewed and scheduled during these appointments, offering patients an option to catch up on any routine health care needs.

Shannon Cliff, who oversees operations for Primary Care for Mayo Clinic Health System in Owatonna and Faribault, says the Owatonna clinic has already seen a positive response.

"Patients really appreciate how convenient the appointments are overall," Cliff says. "We're happy to meet this need for cervical cancer screening in our local community and hope to continue to offer Saturday appointments as long as there is patient demand."

Mayo Clinic recommends that women start cervical cancer screenings at age 21 with a test every three years until age 29, then a test every five years through age 65.

"We know that the earlier we can identify cancerous cells on the cervix, the better treatment outcomes will be for our patients," says Brittany Strelow, D.M.Sc., a physician assistant who leads project efforts. "We also know that finding time to schedule a cervical cancer screening can be tough for many women who are juggling a full workweek along with family schedules. By expanding appointment availability to Saturdays, we're hoping to eliminate at least one barrier to scheduling these important screenings."

Staffed by advanced-practice professionals with a passion for preventive and women's health, the Saturday Pap Clinic was created in response to a survey that asked female patients what barriers they encountered in completing their cervical cancer screening. Appointment availability was the most notable issue, followed by fear or anxiety about the procedure itself.

"I think Saturday appointments have been successful because many providers can relate to our patients' needs in this area," says Strelow. "We're also balancing work with family obligations, so we know flexibility is important."

Those staffing the clinic also walk patients through what to expect and relate to them on a personal level. "We want patients to feel like they're in an environment where people are putting in the extra effort to help things go smoothly," says Strelow.

Patients in Cannon Falls, Lake City, Owatonna and Red Wing can call their primary care clinics to make Saturday appointments on upcoming clinic dates at these locations:

• June 24: Lake City, Owatonna
• July 29: Red Wing, Owatonna
• Aug. 26: Cannon Falls, Owatonna

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About Mayo Clinic Health System

Mayo Clinic Health System has a physical presence in 44 communities and consists of 53 clinics, 16 hospitals and other facilities that serve the health care needs of people in Iowa, Minnesota and Wisconsin. The community-based healthcare professionals, paired with the resources and expertise of Mayo Clinic, enable patients in the region to receive the highest-quality physical and virtual healthcare close to home.

Media contact:

• Kristy Jacobson, Mayo Clinic Communications, newsbureau@mayo.edu

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Dr. Olivia Cardenas-Trowers, a Mayo Clinic urogynecologist, explains the importance of screening for cervical cancer.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (1:00) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

"Cervical cancer is diagnosed with tissue sampling, so like with a biopsy, but abnormal cells can be picked up with a screening exam, like a Pap smear, which can lead to being able to diagnose cervical cancer," says Dr. Cardenas-Trowers.

Screenings are recommended to start at 21 years old, but may start earlier depending on health or risk. Then, depending on age and the type of test, screenings are generally performed every three to five years.

"Early cervical cancer, there aren't really many signs or symptoms. Screening plays a very important role by being able to pick it up early and therefore have treatment and better outcomes," says Dr. Cardenas-Trowers.

If cervical cancer progresses to a later stage, symptoms may include abnormal vaginal bleeding, bleeding after menopause and pain, in general or with intercourse. An HPV infection increases the risk for developing cervical cancer and can be prevented with vaccination.

"There is a vaccine out there that can be given as early as 9 years old and up to 45 years old. (That is) is very important to know, not only for women, but actually for men," says Dr. Cardenas-Trowers.

Related:

• Consumer Health: What is a Pap smear, and who needs one?
• Consumer Health: Understanding cervical cancer risk

For the safety of its patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was recorded prior to COVID-19 or recorded in an area not designated for patient care, where social distancing and other safety protocols were followed.

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Prostate cancer brachytherapy: Can radiation pass to others?
Prostate brachytherapy is a form of radiation therapy used to treat prostate cancer. The radioactive "seeds" are implanted into the prostate gland, so that radiation is delivered directly to the prostate, minimizing radiation to the surrounding tissue. Depending on the type of prostate cancer brachytherapy you receive, your health care provider may recommend some precautions in the weeks after the procedure to protect others. Learn more from Dr. Erik Castle, a Mayo Clinic urologist.

Pap test: Can it detect ovarian cancer?
A Pap test, also called a Pap smear, is a procedure to test for cervical cancer in women. A Pap smear also can detect changes in cervical cells that suggest cancer may develop in the future. If ovarian cancer cells travel away from your ovaries through your fallopian tubes and uterus to the area around your cervix, the ovarian cancer cells could be collected during a Pap test. But this is rare, so the Pap test isn't a reliable test for ovarian cancer. Learn more from Dr. Shannon Laughlin-Tommaso, a Mayo Clinic OB-GYN.

Treatment for breast cancer  
Following a breast cancer diagnosis, your health care provider will establish the extent, or stage, of your cancer. Your treatment options will depend on your type of breast cancer; its stage, grade and size; whether the cancer cells are sensitive to hormones; and your overall health and preferences. Most women undergo surgery for breast cancer and many also receive additional treatment after surgery, such as chemotherapy, hormone therapy or radiation. Chemotherapy also might be used before surgery in certain situations. And men can have breast cancer, too. Tests and treatments for men are similar to those for women, including the use of mammography to investigate changes in breast tissue. Learn more about the treatment options for breast cancer and what you can expect with each.

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Managing your emotions after cancer treatment 
After treatment for cancer, it's common to experience emotions that may be overwhelming: fear of recurrence, depression, anxiety, anger, self-consciousness and more. Take time to acknowledge those feelings. Then take steps to understand why you feel the way you do and what you can do about it. Here are some ideas that may help.

Who needs a Pap smear, when and why? 
A Pap smear, also called a Pap test, is a procedure to test for cervical cancer in women. A Pap smear also can detect changes in cervical cells that suggest cancer may develop in the future. There is a greater chance for a cure when cervical cancer is detected early, so it's important that women have Pap smears as part of their regular health care. Find out the recommended age range and frequency for Pap smears, and what you can expect during the examination.

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The post Women’s Wellness: Still need a Pap smear after hysterectomy? appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Dr. Gregory Poland, director of Mayo Clinic's Vaccine Research Group, will discuss vaccines for vector-borne illnesses, including Lyme disease and Zika virus. Dr. Poland will also discuss the problem of vaccine hesitancy. Also on the program, Dr. Margaret Long, a gynecologist at Mayo Clinic, will explain how the HPV test works differently than a Pap smear. And, Dr. Purna Kashyap and Dr. Vandana Nehra, both gastroenterologists at Mayo Clinic, will share the findings of their research on how your individual gut bacteria may affect your ability to lose weight.

To hear the program, find an affiliate in your area.

Use the hashtag #MayoClinicRadio, and tweet your questions.

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Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

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On the next Mayo Clinic Radio program, Dr. Gregory Poland, director of Mayo Clinic's Vaccine Research Group, will discuss vaccines for vector-borne illnesses, including Lyme disease and Zika virus. Dr. Poland will also discuss the problem of vaccine hesitancy. Also on the program, Dr. Margaret Long, a gynecologist at Mayo Clinic, will explain how the HPV test works differently than a Pap smear. And, Dr. Purna Kashyap and Dr. Vandana Nehra, both gastroenterologists at Mayo Clinic, will share the findings of their research on how your individual gut bacteria may affect your ability to lose weight.

To hear the program, find an affiliate in your area.

Miss the show?  Here's your Mayo Clinic Radio podcast.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

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“The HPV test could potentially replace Pap testing for most women. It’s a better first test than a Pap test,” says Dr. Long, who is not associated with the study. “If your HPV test is negative, the chances of you developing cervical cancer is profoundly low for a long time.”

What is HPV?

HPV is a common virus and can lead to the development of genital warts, abnormal cervical cells or cervical cancer. Nearly 80 million Americans are infected with it, making it the most common sexually transmitted infection in the U.S., according to the Centers for Disease Control and Prevention (CDC).

For most women infected with HPV, the immune system helps prevent the virus from doing harm. But the infection can lead to the development of cancerous cells on the surface of the cervix for a small number of women.

“Virtually everybody that gets cervical cancer has human papillomavirus and, specifically, some high-risk types of human papillomavirus,” Dr. Long says.

Watch: Dr. Margaret Long discusses testing for cervical cancer.

Journalists: Broadcast-quality sound bites with Dr. Long are in the downloads.

How is the HPV test different than a Pap smear?

There is little difference when it comes to the process for collecting an HPV test and a Pap smear, according to Dr. Long. Both tests involve collecting samples of cervical cells using a soft brush and a flat paddle called a "spatula." What’s different is how these samples are tested.

A positive HPV test doesn’t necessarily mean a woman has cervical cancer. It means she has a high-risk form of the virus that can cause cervical cancer.

“If the test is positive, then we would do more testing to find out for sure if there is a risk for cervical cancer or not,” Dr. Long says.

Should women ask for the HPV test?

It is common for women who are getting a Pap test to be given an HPV test at the same time. If you are 30 or older, it is worth asking your health care provider about getting an HPV test in addition to a Pap test, according to Dr. Long.

“I think asking about HPV testing for cervical cancer screening would be a good choice,” Dr. Long says. “If the test is negative, it is very reassuring. If the test is positive, then you have additional testing.”

One benefit of getting the HPV test in addition to the Pap smear is potentially fewer visits to your health care provider. Under current recommendations, women who are age 30 and older who get a Pap test and an HPV test at the same time only need to be tested every five years. For women who only get Pap smears, the recommendations call for testing every three years.

The HPV test is not recommended for women younger than 30 because the potential for cervical cancer is much less and the rates of HPV are much higher. The current recommendation is that women under 30 get a Pap smear every three years.

Why are cervical cancer screenings so important?

Thanks to screenings, the number of women dying every year of cervical cancer has dropped significantly in recent decades.

“With cervical cancer screening, the rates have plummeted and they’re tremendously less than they were before. At this point in time in the United States, most everybody that dies of cervical cancer did not have screenings at all or they didn’t have screening for the last five to 10 years,” Dr. Long says.

Still, an estimated 13,240 cases of invasive cervical cancer are diagnosed every year. About 4,170 women will die from the cancer, according to the American Cancer Society.

Another effective way to prevent cervical cancer is for adolescents and young adults to get the HPV vaccine, Dr. Long says. The CDC recommends routine HPV vaccination at ages 11 or 12. Vaccines can be given to children as young as 9. The HPV vaccine is also recommend for females ages 13 through 26 who have not been adequately vaccinated and males age 13 through 21.

“Pretty much all cervical cancer is caused by high-risk HPV. And even more important than doing screenings is to prevent the HPV infection in the first place. And one of the best ways to do that is for adolescents and young adults is to get the HPV vaccine,” Dr. Long says.

The post Women’s Wellness: Could the HPV test replace the Pap smear? appeared first on Mayo Clinic News Network.

Menstrual dysfunction is one of the most common reasons that women seek out medical care. It can cause significant social and medical consequences if untreated.

The textbook menstrual cycle occurs every 28 days, but a normal cycle may occur as frequently as 21 days or as long as 35 days. The menstrual flow lasts about four to six days and is moderate to mild. Women younger than 20 and older than 40 are more likely to have irregular cycles. The most predictable cycles occur during the optimal reproductive years, ages 20 to 30.

Abnormal menstruation can happen in variouis ways. Bleeding can be heavier (menorrhagia) or lighter (oligomenorrhea) than normal. It can occur too frequently (polymenorrhea) or not frequently enough (oligomenorrhea). Bleeding may occur randomly at no set interval (dysfunctional). The menstrual cycle can be uncomfortable (dysmenorrheal), leading to social consequences such as missed work or school.

The initial step in controlling symptoms of irregular menstrual function is to be seen and evaluated by a health care provider. He or she will look for evidence of medical conditions that can cause menstrual dysfunction. Diabetes mellitus, thyroid disease, kidney disease and blood clotting problems can interfere with the menstrual cycle. In addition, a gynecologic examination with a Pap smear and possible endometrial biopsy may be recommended. Ultrasound of the uterus and ovaries also can help provide information on the cause of bleeding.

Some causes of abnormal bleeding may be related to the anatomy of the uterus. Fibroids (leiomyomas) are benign growths in the uterus that may change the shape of the uterus and interfere with the normal lining of the uterus. Endometrial polyps are growths that originate from the lining of the uterus. They may be benign or precancerous.

Infections can cause temporary menstrual problems. Endometritis, or an infection of the uterine lining, is not a sexually transmitted infection. It can be treated with antibiotics. Other infections such as herpes, gonorrhea, chlamydia and trichomonas, can be detected and treated.

Uterine cancer and the precancer changes can be detected by sampling the uterine lining. These changes are more likely to be found in women nearing menopause or in women who are not ovulating and not using hormonal medications. Treatment will need to be discussed.

If other reasons for menstrual abnormalities are not present, the natural cycle can be modified with medications such as progesterone or progesterone combined with estrogen.

The use of nonsteroidal anti-inflammatory medications also may decrease the amount of bleeding and cramping with each cycle. Outside of hormones, there are limited medical choices to modify the menstrual cycle.

If childbearing has been completed, some women will be candidates for surgical treatments such as endometrial ablation or hysterectomy. These procedures are minimally invasie surgeries usually performed as an outpatient with minimal time off of work. Discuss these options with your health care provider to see if you are a candidate.

Abnormal uterine bleeding can be a social nuisance. It also can be a medical problem that lead to anemia and other health problems. Once in a while, it can signal a more significant problem.  If you have noticed a change in your menstrual cycle or are having problems with it, consult your health care provider to determine your options.

This article is written by Dr. Thomas Howell Jr., an OB-GYN with Mayo Clinic Health System.

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ANSWER: Pelvic exams and Pap smears are not necessary in healthy, adolescent girls who are not sexually active and who do not have gynecologic symptoms or other concerns. The recommended age for young women who have not previously needed a Pap smear to begin having the test is 21. Primary care providers, such as those in family medicine or internal medicine, can perform that exam, or a gynecologist can perform the exam.

In the past, many health care providers used to recommend that teens have a Pap smear at 16 or 18. Now, however, the American College of Physicians does not recommend any routine gynecologic exams for teens at low risk of having the HPV or other sexually transmitted infections.

The purpose of a Pap smear — a procedure that collects cells from the cervix — is to check for changes in those cells that could be a sign of cancer and look for the presence of high-risk types of HPV that are known to cause cervical cancer.

HPV is the most common sexually transmitted infection in the U.S. Although most cases of HPV do not cause symptoms or lead to problems, certain strains of the sexually transmitted HPV are considered high risk, and can lead to cancer and potentially be deadly if left untreated. Two strains of the virus cause 70 percent of all cervical cancer. You can greatly reduce your risk of HPV infection and cervical cancer by getting the HPV vaccine. This anti-cancer vaccine most effectively builds immunity when it’s given between ages 9 and 14.

If you are not sexually active as a teen, in most cases there is no need for a Pap smear because your risk of cervical cancer is low, and you have no risk of HPV or other sexually transmitted infections. Once you begin having sex, a Pap smear may be appropriate. But even in many of those situations, Pap testing still may not need to begin until 21.

Traditionally, some health care providers required a pelvic exam — an evaluation of the vulva, vagina, cervix, ovaries, uterus, rectum and pelvis for any abnormalities — before they would prescribe contraceptives. Again, that is no longer the case. A pelvic exam is not needed to obtain birth control. For most healthy women, the first pelvic exam also can wait until 21.

For young women whose medical history puts them in a higher risk category for infection or cancer, a Pap smear or pelvic exam may be recommended at an earlier age. Those risk factors include a weakened immune system due to chemotherapy, organ transplant or long-term corticosteroid use; exposure to the medication diethylstilbestrol, also known as DES, before birth; and HIV infection.

Some symptoms also may trigger a pelvic exam, such as heavy, painful periods; pelvic pain or pressure; abnormal bleeding or discharge; and itching, pain or lesions in the vulva or vagina. In those situations, a pelvic exam may be necessary, but a Pap smear typically is not required.

When it is time to get a pelvic exam and Pap smear, it’s best to work with a health care provider you know and trust. Before the exam, ask your health care provider about what will happen during the exam and what you can expect. Some providers have anatomical models they can use to describe the procedures beforehand, so you can clearly see what will happen. These procedures are important exams, but they need not be a source of anxiety or fear. If you have questions or concerns, talk to your health care provider. — Dr. Sally Ann Pantin, Family Medicine, Mayo Clinic, Jacksonville, Florida

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