COVID-19 raises concerns and cautions around changing cervical cancer screening practices
Like almost everyone else, I have spent a good amount of time lately reflecting on the impact of COVID-19 over the last two-plus years and the lessons we need to take home as we move forward in our global recovery.
As with many physicians, the early part of the pandemic found me with a smaller-than-usual workload in the office, freeing me up to spend more time with my ill patients and helping out in the hospital and elsewhere in capacities outside of my normal practice spectrum.
During those early days, I certainly worried about my daily exposures and the possible impact they could have on my health and my family’s. I had and have, however, no regrets, understanding that many careers require some personal risk to allow a better, safer society. What I do regret, though, is what I didn’t do during that time.
What I didn’t do through the pandemic was routine, boring, run-of-the-mill preventive health care. Patients were afraid to leave their homes, and well-intentioned local, state and federal policies bolstered their fears and seemingly supported the choice to avoid routine preventive care.
Prospectively there were good reasons for all of this, but as we look back and move forward, the repercussions of these lost encounters are rearing their heads at a disturbing pace. People who deferred preventive care like Pap tests, mammograms and blood pressure/cholesterol checks are showing up in droves with advanced malignancies and cardiovascular disease. Many will fare far worse than they might have if they had not been forced to miss vital health screens.
Moving forward, it is obvious that as a country we must develop plans and strategies to avoid long gaps in preventive care regardless of what other challenges we face. Not doing so, as in suspending preventive care through action or inaction during crisis, will have the same effect as, say, taking off our seat belts to better maneuver a vehicle on a challenging road. We may reduce one singular risk, but we will give up the best safety tool we have.
Based on the above reflections, I urge everyone to get back to their preventive care routines spanning all aspects of medicine.
Within my area of expertise, OB-GYN, I encourage patients to get back on track with annual exams, Pap tests, mammograms, bone density studies and anything else your provider recommends.
The last point is very important, as nuances in individual needs truly require consultation with your provider. In my specialty, for example, many patients are misled by guidelines that suggest cervical cytology, Pap tests, can be done as infrequently as every three to five years.
Patients often conflate the recommended frequency of these studies with the need to come in for yearly visits. Not only are regular exams and discussions required for a myriad of other preventive concerns, but national guidelines often don’t apply to an individual case, leading to confusing and lost care opportunities. Further, many times even without an individual mandate to move beyond standardized guidelines, your provider may recommend a more aggressive screening schedule.
In the case of a Pap test, for example, once a patient is subjected to an exam, she may choose a more frequent screening schedule. After all, national guidelines often sacrifice individual results for health care savings and convenience.
A detailed discussion with your provider may help guide you in terms of tailoring your schedule to best meet your individual needs, not those of a generic patient. Further, benefits of screening may expand beyond a screening’s benefits, such as in early detection of endometrial (uterine) cancer, a cancer often found during the execution of a Pap tests.
These tests were designed to screen for cervical disease but often pick up many disorders that would otherwise be found too late. These benefits are often not considered when practice guidelines are created, especially because guidelines are often made with global health care economics taking a front seat to individual outcomes.
In conclusion, as we all get back to life, please make sure to get back to your primary care providers. Make sure to get any screening you require, and make sure to discuss with your provider what schedule of screening serves you and your individual needs best.
Dr. Arthur Gross is a women's health care provider who has been in private practice in Englewood, New Jersey since 1996. Gross is certified by the American Board of Obstetrics and Gynecology and is an attending physician at Englewood Health.
This article originally appeared on NorthJersey.com: Even with COVID-19, it's time for a return to preventive care
