Women who have a tubal ligation – the surgical tying or severing of fallopian tubes to prohibit pregnancy – have less frequent Pap smears, which puts them at an increased risk for cervical cancer, according to research recently released by a team that included Cara A. Mathews, MD, a gynecologic oncologist at the Program in Women’s Oncology at Women & Infants Hospital of Rhode Island.
The findings were part of the National Cancer Institute-funded study “Study to Understand Cervical Cancer Endpoints and Determinants” being conducted when Dr. Mathews was a fellow at the University of Oklahoma. The results were published in late 2012 in the professional journal Gynecologic Oncology.
The objective, according to Dr. Mathews, was to investigate any connection between different types of contraception, screening frequency and cancer rates. Study participants were women who underwent a colposcopy after having an abnormal Pap test. The researchers used a questionnaire to identify factors associated with the cancer, including the frequency that the women went for Pap tests.
A Pap test checks for changes in the cells of a woman’s cervix. The test can tell if the woman has an infection, abnormal cervical cells or cervical cancer, and has led to a major decline in the number of cervical cancer cases and deaths.
“Previously, we have advised women to have a Pap test every two years starting at age 21,” Dr. Mathews explains. “Women over the age of 30 with three or more normal Pap tests were able to space screening intervals to every three years. And women over 65 without risk factors do not need to keep screening.”
She and her colleagues, however, discovered that women who have had a tubal ligation were not as likely to have regular Pap tests.
“In all age groups, women with tubal ligation were more likely to have had no Pap screening in the previous five years compared to women using other forms of contraception,” Dr. Mathews reveals.
The research publication came on the tail of new recommended Pap guidelines from the American College of Gynecology (ACOG), which state that women between 21 and 65 without risk factors should be screened every three years. Women ages 30 to 65 who want to extend the screening interval can go every five years.
“In issuing the new guidelines, ACOG stressed the importance of emphasizing well visits and screenings in women, including the Pap test, to promote health and prevent cancer,” Dr. Mathews concludes.
Women & Infants Hospital