Back to basics
Women, don’t delay mammograms, other important cancer screenings
Diane Crawford always went to her routine gynecology appointments and had never had an unnerving pap test result — until August of 2009, when Crawford was diagnosed with earlystage cervical cancer. h She credited early and routine screening for saving her life and said it could save the lives of other women if they continue their regular appointments. h “Women, don’t miss that. If I would have missed my annual exam that year, I honestly don’t think that I would be here,” said Crawford, 54, of Westerville.
In March 2020, elective medical procedures and non-emergent screenings like routine mammograms and pap tests, which can detect early signs of breast and cervical cancer, respectively, ground to a halt.
More than a year into the pandemic, health care experts and say these screenings save lives and should become part of a patient’s routine again now that they’re available again.
The public listened when they were asked to stay home and avoid health care facilities for non-emergencies, but it’s hard to get people back into the system, said Dr. David Cohn, chief medical officer at
Ohio State University’s James Cancer Hospital.
It’s not a problem unique to Ohio. Cervical cancer screenings, for instance, fell 80% during California’s stay-at-home order, according to a study by the Centers for Disease Control and Prevention. While they rebounded between mid-june and September 2020, after the stay-at-home order was lifted, they were still 24% to 29% lower than in 2019.
“If somebody waits a few months for screening, that’s going to be fine. …,” Cohn said. “But when a few months turns into a few years, that’s when you can start to really see the impact of cancer death rates increasing over time.”
Mammograms should be done yearly after the age of 40 and pap tests every three to five years after the age of 21, said Dr. Jason Melillo, the medical director of women’s health at Ohiohealth. While breast cancer is common and affects one in eight women, cervical cancer is less prevalent, he said.
Doctors recently noticed that swollen lymph nodes caused by COVID-19 vaccines can produce “false positives” in mammograms, according to Ohiohealth.
And they’re suggesting that women schedule a screening before receiving the vaccine or wait four to six weeks after getting the vaccine.
It is fairly common, in Melillo’s experience, to catch cancer early if patient keep up with routine exams.
“I’ve had several patients over my 27year career who were doing routine breast exams, were coming in for their annual exams and having a clinical breast exam, and on whom we found very early signs of changes that turned out to be either precancerous or very early-stage cancer that we were able to intervene and prevent them from having to have significant surgeries like a full mastectomy or chemotherapy,” he said.
After her diagnosis, Crawford underwent a radical hysterectomy — which involves removing the uterus, cervix, tissue around the cervix and the upper part of the vagina — and had 32 lymph nodes removed.
Because her cancer was in its early stages, she qualified for a robotic surgery that resulted in less trauma and healing time.
Her cancer hadn’t had time to spread, therefore no post-surgery radiation or chemotherapy was required, Crawford said.
Just months after her diagnosis, Crawford established a fund at the James Cancer Hospital to raise money for cervical cancer treatment. That in turn, led her to create The Crawford Crew, a nonprofit group that raises awareness and educates people about preventing cervical cancer and advocates for new innovative research.
“It’s a little hard because people are embarrassed or shy or what have you, so it’s definitely a challenge for us. But … It’s a challenge accepted, and we continue to find volunteers who have no problem talking about sexual relations and how we have to make sure we’re mindful,” Crawford said.
Melillo said cervical cancer can be caused by smoking or exposure to HPV, of which some variations are protected against by vaccine. Breast cancer, on the other hand, is far more common and is influenced by a family history of breast and ovarian cancer as well as mutations to the BRCA gene, which is linked to a predisposition for breast cancer.
Colon cancer is the third most common cancer in women, Cohn said, so regular colonoscopies should also be scheduled for those over 50. Lung cancer, which is more malignant in women than in men, should also be screened for in current and former tobacco users, starting at age 55, he said.
The best type of cancer to have is one that never develops, Cohn said. And the best way to prevent that from happening is through regular screenings, which are now safe again, he said.
“You’d hate to have gotten through the pandemic only to be diagnosed with a cancer and reverse all of the efforts that we just made,” Cohn said. “And so, if the goal at the end of the pandemic is to get back towards normal, we’d love to have the new normal be one without cancer as well.” @sam_raudins sraudins@gannett.com
Mammograms should be done yearly after the age of 40 and pap tests every three to five years after the age of 21, said Dr. Jason Melillo, the medical director of women’s health at Ohiohealth.