9:00 AM Monday morning:
I’m in a tiny room at my doctor’s office staring at stirrups. If you are unfamiliar with stirrups (and if you are, I am going to assume you are a man), they are two folding metal arms that protrude from the foot of a gynecological exam table, otherwise know as the most uncomfortable bed in the world. If you are lucky, the little foot rests at the ends have socks on them. I am not lucky today. My feet will be on the cold bare metal. I strip down to the nothing and don a comically thin paper gown (Opening in the front! I have to remind myself every time) and hop up on the table where I drape a thin paper sheet over my lap and wait for the doctor to arrive.
It’s been three years since my last pap smear.
While I don’t find the process as unpleasant as many women, until recently, I did think that a yearly exam was a bit of an overkill. According to medical research, I belong to a demographic of women with very low risk for cervical cancer so I assumed that the current recommendation of once every three years was more than adequate. According to the CDC, your risk of cervical cancer may be increased by:
- Contracting HPV.
- Having HIV (the virus that causes AIDS) or other condition that makes it hard for your body to fight off health problems.
- Using birth control pills for a long time (five or more years).
- Having given birth to three or more children (full term births).
- Having several sexual partners.
I fall under none of these categories. I don’t smoke, took the pill for only three years, have had two full term births and my husband and I have been each others only sexual partners. In a previous, more judgmental time in my life, I would have told you that I am a “good girl” and good girls don’t get cervical cancer.
But I would have been wrong.
My mother-in-law was a good girl.
She never smoked, never drank, also only had two full term births, a single sexual partner and as far as I know, never took the pill. There’s no history of reproductive cancers in her family. So, like me, she felt no particular urgency to get regular pap smears. Besides, she probably reasoned, she was in her sixties and with a lifetime of normal results. there was really no reason to continue them at all. The U.S. Preventative Task Force says the screenings for women in her age and risk bracket provide “little to no benefits”.
On May 19th this year – at the age of 65 and four years after her last pap, my mother-in-law sought medical attention for what she thought was nothing more than a particularly stubborn UTI. It turned out to be Stage IV adenocarcinoma that had already metastasized to her bladder, liver and lungs. Despite radiation and chemotherapy, the cancer spread quickly and aggressively. She died less than nine weeks later in the house she grew up in, the same house her mother lived in until the ripe old age of 96. The shock at the diagnosis and the speed at which we lost her left the whole family devastated and breathless.
My mother-in-law did everything right.
She followed the medical recommendations. She limited her risk. She was a “good girl”….and she died. There is no way to know if pap smear would have detected her cancer early enough to prevent her death. I’ll tell you what: I would really have liked the chance to find out.
“Get a good sample for me.”
So, here I am, feet up in the cold stirrups doing what I can to live as long as I can for my husband, for my children, for my friends. I tell the doctor my mother-in-law’s story. When she pulls out the cytobrush to get the smear of cervical cells, I say, “Get a good sample for me!” I’m joking…but not really.
The recommendation may be once every three years for women 21 -65, but I plan on getting a pap smear once year for as long as I can. I’d happily trade a few seconds of mild discomfort if it could mean another 30 years with people I love. I hope you would too. If you haven’t had a pap smear in the last year, I encourage you to call today and schedule one.
It’s what a good girl does.
For programs offering free or low cost breast and cervical cancer screening, please visit the CDC website here.
Tell me what you think! Do you follow the once every three year recommendation or do you go every year? Have you made your appointment for this year?