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Regular cancer screenings are still important in times of the pandemic, especially for cancers that do not generally show symptoms in their early stages. This includes cervical cancer, which does not show symptoms “until the cancer becomes larger and grows into nearby tissue,” the American Cancer Society said.

When symptoms do present, they can include:

• Abnormal vaginal bleeding, such as bleeding after vaginal sex, bleeding after menopause, bleeding and spotting between periods, or having menstrual periods that are longer or heavier than usual.
• An unusual discharge from the vagina – the discharge may contain some blood and may occur between periods or after menopause
• Pain during sex
• Pain in the pelvic region
• When it is more advanced, symptoms can include swelling of the legs, problems urinating or having a bowel movement, or blood in the urine.

“If you had an appointment for screening that was postponed or canceled, talk to your healthcare team about when to reschedule,” the American Cancer Society advised on their website. “Your provider can discuss balancing the risks and benefits of being screened now or postponing for a later date, taking into account your personal and family history, other risk factors, and the timing of your last screening test.”

David Billings, MD, FACOG, an Ob-Gyn with Trinity Health, believes that women have been more cautious in coming out for annual exams because of the pandemic. “As long as they come in within a reasonable time, as things hopefully improve, it should not be too much of an issue, but they still should not put it off too long.”

In 2020, it was estimated that about 13,800 new cases of invasive cervical cancer would be diagnosed, and that 4,290 women would die from the disease, which has been classified as the fourth most common type of cancer for women worldwide.

Cervical cancer is also one of the most preventable types of cancer because it develops over time. Deaths from cervical cancer have declined at a rate of approximately 2 percent per year, primarily due to the widespread use of Pap smears to detect cervical abnormalities and allow for early treatment, the National Cervical Cancer Coalition said.

According to the National Cancer Institute, a pap smear is a procedure in which cells are gently removed from the cervix. These cells are then checked under a microscope to look for cervical cancer or cell changes that could lead to cervical cancer. Pap smears, which can also help detect infections or inflammation, can be done at the same time as a pelvic exam.

During a pelvic exam, a doctor – usually an Ob-Gyn, midwife, or a women’s health nurse practitioner – evaluates a patient’s reproductive organs for any abnormalities. A pelvic exam can be a part of a regular checkup or recommended if a patient has symptoms.

Cervical cancer tends to occur in women during midlife; it is frequently diagnosed in women between the ages of 35 and 44. “It rarely affects women under age 20, and more than 15 percent of diagnoses are made in women older than 65,” the National Cervical Cancer Coalition’s website stated. “But in women over 65, cancer typically occurs in women who were not receiving regular screening.”

After the initial Pap smear, which should be performed starting at 21, women should get one every three years between the ages of 21 to 29, unless recommended otherwise. From age 30 to 65, testing is done every three years or every five years when combined with human papillomavirus (HPV) screening. After the age of 65, women who do not have a high risk for cervical cancer should avoid screening.

Women who smoke are about twice as likely as non-smokers to get cervical cancer, the American Cancer Society said. Other risk factors for cervical cancer include HPV infection – the most important risk factor – as well as having a weakened immune system, chlamydia infection, a diet low in fruits and vegetables, being overweight, along-term use of oral contraceptives, intrauterine device (IUD) use, having multiple full-term pregnancies, being younger than 17 at your first full-term pregnancy, and having a family history of cervical cancer. (Regarding family history, the American Cancer Society said that having a mother or sister that had cervical cancer increases the chances of a person developing the disease.)

Trinity Health’s Ob-Gyn department includes: Heather Bedell, MD; Tim Bedell, MD; and Jennifer Johnson, MD, located at Health Center – Medical Arts, 400 Burdick Expy E, Minot. For appointments, call 701-857-7397.

Lori Dockter, PA-C, is also located at Health Center – Medical Arts. For appointments, call 701-857-5050. J. David Amsbury, DO, and midwives Jayme Burman, CNM, and Erica Riordan, CNM, also are based at Health Center – Medical Arts. For appointments, call 701-857-7385.

David Billings, MD, FACOG, is located at Health Center – Town & Country, Ste 101, 831 S Broadway. For appointments, call 701-857-7394. Jessie Fauntleroy, MD; Margaret Nordell, MD; and Carol Schaffner, MD, along with midwife Gloria Berg, CNM, are located at Health Center – Town & Country, Ste 102, 831 S Broadway, Minot. For appointments, call 701-857-5703.

Heidi Lynn Grondahl, WHNP-BC, is based at Trinity Community Clinic – Western Dakota, 1321 W Dakota Pkwy, Williston. For appointments, call 701-572-7711.