Risk for Certain Gynecologic Cancers Increase as Women Grow Older
Shohreh Shahabi, M.D.
Chairman, Department of Obstetrics, Gynecology and Reproductive Biology
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What Every Woman Should Know
Just because you may be beyond the "childbearing years" doesn't mean you should forego regular appointments with your obstetrician/gynecologist. In fact, as you grow older, your risk for certain gynecologic cancers actually increases. Shohreh Shahabi, MD, FACOG, Chairman, Department of Obstetrics, Gynecology and Reproductive Biology, leads the team of more than 30 affiliated obstetrician/gynecologists throughout Western Connecticut Health Network working to address the changing health needs of women as they age.
"Many women's cancers can be without symptoms in their earliest stages, which makes physician exams and recommended screenings an important part of every mature women's health regimen," explained Dr. Shahabi, who is a fellowship-trained surgical specialist in gynecologic oncology, and serves as Chair of the Reproductive Tumor Biology Research Laboratory. Dr. Shahabi offers these insights on the "big three" gynecologic cancers to support greater awareness and early detection.
The cervix connects the body of the uterus (womb) to the vagina. While the death rate has been in a steady decline since widespread use of the Pap test (effective in detecting early cases of cervical cancer), more lives could be saved if all women were diligent about routine screenings.
According to Dr. Shahabi, the most important risk factor for cervical cancer is infection by the sexually transmitted human papillomavirus (HPV), a group of more than 150 types of viruses that can cause warts. Since having many sexual partners, intercourse at an early age and unprotected sex at any age raises your risk of HPV, experts consider those behaviors to raise your risk for cervical cancer as well. Exposure to chlamydia, another vaginal infection, and being HIV positive also increases your risk. Other risk factors for cervical cancer as women age include smoking, a diets low in fruits and vegetables, long-term use of oral contraceptives, and a family history of cervical cancer.
The ovaries are two small organs located on each side of the uterus that produce female hormones and store eggs. Ovarian cancer is often described as a "silent" cancer because it typically causes no symptoms until it is quite advanced. The outlook for women who have early ovarian cancer is good, but only about one-fourth of the cases are detected at this stage.
Contrary to what some women believe, a Pap test rarely detects ovarian cancer. While there is no effective ovarian cancer screening test, risk factors include a personal history of breast cancer, a family history of ovarian or colorectal cancer, being over age 50, the presence of an inherited BRCA breast cancer gene mutation, a history of early menstruation or late menopause, a first pregnancy after age 30 or no children at all and a high fat diet.
"Pay attention to warning signs, which include a feeling of fullness or discomfort in the pelvic region, abdominal discomfort or swelling, pain during intercourse and sometimes abnormal bleeding," cautioned Dr. Shahabi. "If you have new symptoms that persist, don't hesitate to see your gynecologist."
Endometrial and Uterine Cancers
The uterus is a hollow pear-shaped organ with a lining that is called the endometrium. Ninety-five percent of endometrial or uterine cancers occur in women age 40 or older. In addition to your age, risk factors for these cancers include:
- Early menstruation (before age 12) or late menopause (after age 50)
- A history of infertility or having never given birth
- Exposure to tamoxifen (a drug used for breast cancer)
- Estrogen replacement therapy or pelvic radiation therapy
- A family history of endometrial or colon cancer
- A diet high in animal fat
- Obesity and diabetes
Currently, there is no single good screening test for endometrial or uterine cancer. Although the pelvic exam and Pap test can detect occasional cases, most are not discovered this way. However, 90 percent of patients diagnosed with endometrial or uterine cancer reported postmenopausal bleeding or irregular vaginal discharge. Although these symptoms can occur with other noncancerous conditions, it is important to have an immediate medical evaluation of these symptoms.
When to have a Pap
According to the American Cancer Society, pap tests are recommended annually after age 21, and less frequently for women who have had normal Pap tests, and after total hysterectomy.
"No matter what your age, it's important to discuss these issues with your doctor and follow his or her recommendations on Pap test frequency," said Dr. Shahabi. "You can never be too careful when it comes to your gynecological health."
For more information on gynecological oncology care at Western Connecticut Health Network or to Find a Doctor, visit online at DanburyHospoital.org and New Milford Hospital.org, or call 1-800-516-4743.
About Western Connecticut Health Network
Western Connecticut Health Network is the region's premier, patient-centered health care organization serving residents of Western Connecticut and adjacent New York. The organization is anchored by two nationally recognized hospitals, Danbury Hospital and New Milford Hospital, as well as their affiliated organizations. In addition to the two hospitals, the continuum of care offered includes the following affiliates:
- Western Connecticut Medical Group, an integrated physician practice with primary and specialty care expertise
- Western Connecticut Home Care, an agency for home care and community health services
- The Western Connecticut Health Network Foundations
- emergency medical and Level II trauma services
- an occupational wellness and medicine program, providing services for business and industry
- a nationally renowned Biomedical Research Institute
Western Connecticut Health Network has centers of excellence in women's health, cardiovascular and cancer services; minimally invasive joint and spine surgery; digestive disorders, weight-loss (bariatric) surgery, and radiology and diagnostic imaging. It also offers specialized programs for neonatology with a Level IIIb neonatal intensive care unit and accredited sleep disorder centers. Both hospitals also maintain active clinical research programs, offering clinical trials for patients with cancer and other health concerns. Danbury Hospital was named a Top 100 Hospital by US News and World reports in 2012; a and a Top 100 for Value by Cleverly and Associates. New Milford Hospital is well known as a Planetree hospital and for its Plow to Plate, farm to table food program.
For more information, visit WesternConnecticutHealthNetwork.org, DanburyHospital.org; NewMilfordHospital.org and share your comments with us at Facebook.com/DanburyHospital or Facebook.com/NewMilfordHospital.
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