Twenty-five percent of cervical cancer occurs in women over age 65, most of whom did not have regular PAP smears at an earlier age. It is often a lack of understanding and fear of the unknown that prevent women from using this simple, inexpensive and effective method of screening for cervical cancer and choosing the most appropriate therapy.

Just what is a PAP test and what does an abnormal result mean? A PAP smear is simply a sample of cells taken from the surface of the cervix during a routine gynecological exam. (The cervix is the lower end of the uterus, which extends down into the vagina about one inch). The cells are then applied to a slide and viewed microscopically to determine if they are normal and free of infection that may progress to cervical cancer.

The PAP test was developed in the 1930's by a Greek physician, Dr. Papanicolaou, and was later abbreviated to "PAP" smear. Several major risk factors predispose to the development of cervical cancer: (1) sexual intercourse before age 20, (2) multiple sexual partners, 3) cigarette smoking and (4) infection with Human Papilloma Virus (HPV).

The incidence of HPV infection has dramatically increased. It is estimated that15-25% of the population of the U.S. has been exposed to HPV. Another virus, Herpes Simplex II, is considered a co-factor for cervical cancer, as well.

Abnormal PAP tests range from detecting mild inflammation to invasive cancerous cells. If these cellular abnormalities are discovered and treated at an early stage, more invasive therapies to treat cervical cancer may be avoided. Failure to do so may allow inflammatory changes to progress to cancer of the cervix, uterus and the rest of the body. This can be prevented by early detection through screening all appropriate women with regular PAP smears. Women who have one or more risk factors simply must be screened yearly. All women over the age of18 or who have been sexually active should be tested every year. Such testing should continue until age 65, after which it may be discontinued if two consecutive normal smears are obtained.

If an abnormality (such as inflammation) is detected, appropriate treatment is begun and the PAP test is repeated in 3 months. If inflammation persists three months following treatment, we refer to a gynecologist for a diagnostic test called "colposcopy".

It is a brief, in-office procedure which involves direct microscopic exam of the cervix, during which a biopsy can be taken. Depending on the degree of cellular abnormality detected, various treatments are available.

Conventional medicine uses surgical removal of the abnormal area by scalpel, laser, cryosurgery (freezing) or more recently, by a technique called Loop Electrosurgical Excision Procedure (LEEP). All are effective at removing the zone of abnormal cellular growth, but like most procedures, have some drawbacks.

It is important to remember that since these cellular changes may be caused by a virus, systemic treatment which strengthens the immune system may be essential to any permanent cure. Because many women choose not to use surgery as a first line of treatment, they come to Naturopathic physicians seeking an alternative.

For decades, Naturopathic doctors have been using an eclectic approach and getting remarkable results. This treatment consists of the topical application of specific herbs, enzymes and herbal suppositories for 6 weeks. Specific nutrients that have been demonstrated to assist the cervical cells in returning to normal structure are recommended . Also, appropriate lifestyle and dietary measures are explained and initiated.

Portland's National College of Naturopathic Medicine has just completed a preliminary study of 43 women with abnormal PAP smears, measuring the effectiveness of such treatment. Of the 43 women, ten had carcinoma in situ (cancer localized to the superficial layers of the cervix). Following the study, 38 patient's PAP tests had returned to normal, 3 showed partial improvement and 2 remained the same. No one in the study worsened.

These are very encouraging results that warrant more extensive studies, which are ongoing. If you or a friend have recently had an abnormal PAP test, discuss with your naturopathic doctor whether you might be a good candidate to utilize this protocol as a first line of treatment.