By Debbie Saslow, PhD

When it comes to screening for cancer, a common belief held by doctors as well as patients is "more is better." It seems only logical that more frequent screening with the newest technologies translates to more cancers detected at the earliest possible time and, ultimately, more lives saved.

Cervical cancer is an example of why this is not necessarily so. Dating back to the late 1940s, the Pap test has been detecting not only early cervical cancers, but changes in the cervix ("pre-cancers") that when treated or removed lead to actual prevention of cancer in addition to early detection. For decades, the majority of women in this country have scheduled their doctor appointments around their "annual Pap."  As a result of widespread Pap testing, mortality rates dropped by 70% and the Pap test became the biggest success story for cancer screening in history.

In the late 1980s, it was discovered that cervical cancer is caused by HPV, the human papilloma virus. Studies of the natural history of HPV and cervical cancer showed that it takes, on average, 10-20 years from the time a woman is first infected with HPV until the time a cervical cancer might appear.

In 1987, the American Cancer Society, and several other national organizations, recommended that most women could safely be screened for cervical cancer with the Pap test every 3 years rather than every year. Twenty-five years later, studies show that the majority of health care providers still recommend annual screenings and that the majority of women expect annual screenings. More...

By Debbie Saslow, PhD

For years, patients, doctors, and researchers have been trying to find a way to catch ovarian cancer early, when it's most treatable. For women, the chance of getting ovarian cancer is about 1 in 70.  In most cases, the cancer is found at an advanced stage and survival is, sadly, quite low.

Most women get tested regularly for breast cancer and cervical cancer, and hopefully colorectal (colon) cancer. Why aren't they checked for ovarian cancer, too?  Unfortunately we don't have tests like mammograms or Pap tests for the ovaries. Doctors often do a pelvic exam, which includes checking the ovaries, but this exam rarely finds ovarian tumors unless they have grown very large.

Some other tests, like the CA-125 blood test and transvaginal ultrasound, have been studied to see if they can be used to test for ovarian cancer, but none have proven to be accurate enough to consistently find cancer. More...

By Debbie Saslow, PhD

Many people ask me about whether or not their daughters should get the human papillomavirus (HPV) vaccine, which can help prevent cervical cancer. As with all new vaccines, there has been some controversy. Some parents have been reluctant to get their daughters vaccinated before they are sexually active, yet this is precisely when the vaccine will be most effective. Others were concerned about safety; the HPV vaccines are extremely safe, based on tens of millions of doses distributed worldwide. There was also an initial push, generated by the manufacturer, to require HPV vaccination for middle school enrollment. To date only Virginia and Washington, D.C., have such a requirement.

To answer the question of whether to vaccinate, it helps to have some background:

In the United States, an estimated 12,200 cases of invasive cervical cancer were expected to be diagnosed in 2010, with an estimated 4,210 deaths. But there have been fewer deaths over the past several decades due to cancer screening tests. That's great news. But we can reduce the number of people even getting cervical cancer by doing what  we know works. More...

By Debbie Saslow, PhD

A recent study has shown that for some women diagnosed with breast cancer, extensive lymph node surgery isn't needed. This is great news because removal of lymph nodes in the armpit area can have debilitating and life-long side effects.

Here is a little background: In the United States, about 210,000 new cases of invasive breast cancer will be diagnosed this year. Of the invasive cancers, about 30% of cases, or 63,000 cancers, will be diagnosed at the "regional stage," which means the cancer has spread to nearby lymph nodes. The findings of this study are important for women in this group.

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