LANDSTUHL REGIONAL MEDICAL CENTER, Germany -- As a Certified Nurse- Midwife for 22 years, I know that not one single woman needs to die from cervical cancer because it can be prevented. My coworkers and I at Landstuhl Regional Medical Center work to raise awareness about cervical cancer because we want to try to protect our patients, including you and your loved ones.

In 2017 alone, there were nearly 13,000 new cervical cancer cases and over 4,200 deaths in the United States, and over 275,000 deaths worldwide. Cervical cancer is the third highest gynecological cancer in the United States. We are truly fortunate to be here in the KMCC community where we have access to screening and prevention. January is Cervical Cancer Awareness month and I have much to share with my patients in educating our mothers, wives, daughters and sons.

Where does this unseen killer come from? Twenty years ago, when I first scraped cells from my patient's cervix and put them on a slide, a pathology technician looked to see if they were abnormal. Today we know that HPV, the Human Papilloma Virus, is present in over 99.7 percent of cervical cancers. There are 13 out of over 50 strains that are known to produce cancer. Other strains can cause genital warts and these we can see, but the real killer is quiet, not easily viewed and may take years from first exposure until the first warning signs of bleeding and pain.

I feel it is important for you, my patients, to know who is at risk for cervical cancer and the importance of prevention. Some women are more at risk than others. Women who smoke, have multiple partners and those with a history of a sexually transmitted infection are at greater risk. I encourage you to not smoke, to use condoms to prevent sexually transmitted diseases and to make healthy lifestyle choices.

Smoking, in particular, tobacco, has been found in greater amounts in cervical mucous than in the lungs of women who smoke. It damages epithelial cells, like those that line the lungs and the cervix. Another way to prevent cervical cancer is to get the HPV vaccine. This vaccine is a three-part series, and it is offered to both girls and boys, beginning at age 11 and up to age 26.

Studies tell us that up to 50 percent of teens over the age of 15 are sexually active. If we vaccinate them before they engage in sexual activity, we may prevent half of all cervical cancers. This simple vaccine can prevent a lot of pain and discomfort from additional procedures and treatments, protecting the patient but also their future partners.

Some patients request a Pap smear every year, concerned that something might be missed or they tell me about their family's history of other female cancers. I want to reassure you with education and the latest studies. I advise patients to return for annual Well Woman Exams. During this visit I perform a head to toe assessment, including visualizing the cervix. As cervical cancer takes years to progress and the majority of women can clear the HPV infection within 8-24 months, the initial Pap smears are three years apart, beginning at age 21 and continuing until age 30.

As we get older, the initial risk of contracting the virus decreases, but the possibility of persistent HPV infection increases. Therefore, we co-test with the PAP smear and HPV screen every five years, from age 30 to 65.

Let me leave you with some final words of advice from a provider and her colleagues who care about the health and wellbeing of our patients, their spouses, and children. Get your recommended screenings. Make healthy lifestyle choices. Get your HPV vaccine at your immunization clinic. Do not smoke, if you do, please let us help you quit. Has it been a year since your last Well Woman Exam? Make an appointment for yourself or someone you love today, you'll be glad you did.

Your Women's Health Care Provider
Katherine W. Coughlin, Certified Nurse Midwife
Department of Obstetrics and Gynecology
Landstuhl Regional Medical Center, Germany