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Assess risk of cervical cancer, HPV
Health advice
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January is National Cervical Health Awareness Month, so here is information on cervical cancer and assessing your or your loved ones’ risk for this disease.
Cervical cancer is a common kind of cancer in women. It is a disease in which malignant cells are found in the tissues of the cervix, which is the opening of the uterus. Before cancer cells are found on the cervix, the cervical tissues go through changes in which abnormal cells begin to appear. This condition is called “dysplasia.” Later, the cancer starts to grow and spread deeper into the cervix and surrounding areas.
According to the National Cancer Institute, strong risk factors include:
• early age of first intercourse
• a history of multiple sexual partners
• genital human papillomavirus (HPV) infection or other sexually transmitted diseases
• a presence or history of other genital tract abnormalities
HPV is a group of viruses that includes more than 100 different strains or types. More than 30 of these viruses are sexually transmitted. Most people get HPV soon after they start having sex. The majority of people who become infected with HPV will not have any symptoms and the infection will clear up on its own. However, HPV can cause normal cervical cells to turn abnormal. If HPV goes away, the cervical cells go back to normal. But if HPV lingers for many years, the abnormal cells can turn into cancer.
There is no treatment for HPV, but there is a vaccine that protects against the four HPV types that cause most cervical cancers and genital warts. This vaccine is most effective in females who have not yet had sex. But young, sexually active females still may benefit. The Gardasil vaccine is given for young females between the ages of 9 and 26.
Women age 60 and older are at greater risk for cervical cancer than women in other age groups because they are less willing or able to seek early screening, according to www.gachd.org. Some risk factors, according to the National Cancer Institute, include active or second-hand smoking, poor nutrition and a current or past sexual partner with risk factors for STDs or HIV/AIDS.
There are no real symptoms of the early stages of cervical cancer. That is why is it is so important that your doctor does a series of tests regularly to look for it.
The first of these is a pap smear, which is done by using a piece of cotton, a brush or a small wooden stick to gently scrape the outside of the cervix to retrieve cells that can be examined under a microscope.
Women who are or have been sexually active, or have reached age 18, should have pap tests and physical exams regularly. Older women should continue to have regular physical exams, including pelvic exams and pap tests. Women who have had consistently normal pap test results may want to ask the doctor how often they need to have a pap test.
Women who have had a hysterectomy should talk with their doctor about whether to continue to have regular pap tests. If the hysterectomy was performed for treatment of a pre-cancerous or cancerous condition, the area still needs to be sampled for abnormal changes. If the hysterectomy was performed because of a non-cancerous condition, such as fibroids, routine pap tests may not be necessary. However, it still is important for a woman to have regular gynecologic examinations as part of her health care.

Ratcliffe is a consultant to the Coastal Health District. You can call her at 876-6399.

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From the book 'Outliers' comes proof that good health is more than just genetics
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Friends Jim Young, left, Mike Natale, Jeff Natale and Ryan Kiernan were on Greenwich High School football team together and Jim and Mike were captains. Jim, who was the youngest in Sherry Young's family, was welcome in the homes of the other three boys who still had siblings around and grandparents near. - photo by Sherry Young
As I look back on my life and the lives of others, both personally and in the reading I have done, I am convinced of the necessity of positive human contact in our lives. We are doubly blessed when we are able to make good friends or are a part of a family where we are accepted and loved.

Malcolm Gladwell in his book Outliers tells of a time in the 1950s when Dr. Stewart Wolf met a physician who practiced in the area of Roseto, Pennsylvania. Roseto was settled by a group of Italian families from Roseto, Italy, who re-created their life again in America.

This was in the 1950s before drugs and measures to prevent heart disease became important. In their conversation the physician said, You know, Ive been practicing for 17 years. I get patients from all over, and I rarely find anyone from Roseto under the age of 65 with heart disease.

Wolf was surprised by these words as, It was impossible to be a doctor, common sense said, and not see heart disease.

Wolf enlisted the aid of a sociologist and friend John Bruhn to help him. They found, There was no suicide, no alcoholism, no drug addiction, and very little crime. They didnt have anyone on welfare. Then we looked at peptic ulcers. They didnt have any of those either. These people were dying of old age. Thats it.

They checked into diet, genetics and possibilities of something in the foothills of eastern Pennsylvania but nothing made sense.

What they found was that Rosetans visited one another, stopping to chat in Italian on the street, say, or cooking for one another in their backyards. (Researchers) learned about the extended family clans that underlay the towns social structure. They saw how many homes had three generations living under one roof and how much respect grandparents commanded. They went to Mass at Our Lady of Mount Carmel and saw the unifying and calming effect of the church. They counted 22 separate civic organizations in a town of just under 2,000 people. They picked up on the particular egalitarian ethos of the community, which discouraged the wealthy from flaunting their success and helped the unsuccessful obscure their failures.

What they found eventually convinced the medical establishment to look beyond the individual and understand the culture people are part of their friends, families and town they came from. They determined that the people we surround ourselves with and the values of the world we inhabit have a profound effect on who we are.

Likely, this study could have been done with other ethnicities. However, my family's experiences with the Italian families in Connecticut ring true to the study. Our hungry and growing sons, especially our youngest son, Jim, who was left home alone with two beady-eyed parents, all had some memorable experiences being fed and loved in the Cos Cob multigenerational families. Proof of the African proverb, It takes a village to raise a child.

We live in an age when the contact we have with people often is on the internet, and many of us live among strangers. Unless we make the effort to reach out, we will become isolated, especially as we age. The Rosetan study is proof that reaching out and communicating may be good for our health.
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