The average doctor may suggest that you get the typical Pap test once a year. However, recent studies suggest that cervical lesions may differ dramatically among different races, especially for Hispanic and African American women.
The variation in precancerous cells found in the cervix that progress toward becoming cancerous or regress toward normal cells vary at high rates among Hispanic, African American, Caucasian, and Asian women.
Analyzing over 5,472 medical records of women who received a Pap test from January 2006 to September 2016, they found that Hispanic women progressed the fastest, moving from innocuous to worrisome high-grade lesions within 17.6 months. In comparison to African American women, it took 10 additional months to reach that same critical state. However, Hispanic women recovered faster too, regressing from high-grade to innocuous lesions in 28.1 months. On average, African American women took 49 months to regress back to the innocuous stage.
Strangely enough, progression and regression rates of precancerous lesions for Caucasian and Asian women fell somewhere in between, which in fact, reflects closely the expected patterns upon which current treatment guidelines are based upon and used in most health care and OB/GYN facilities.
“We see race-based differences that influence treatment protocols in all manner of health issues," said Daniel Martingano, DO, an OB/GYN at New York University Langone Hospital – Brooklyn and lead author on this study. “Unfortunately, screening and treatment guidelines for precancerous lesions have not yet benefited from that additional layer of context. This study is the first step toward more precise and effective care."making their treatment decisions and hopes it leads to fewer women undergoing aggressive and invasive procedures.
Why get a Pap smear?
According to The Journal of the American Osteopathic Association, it’s typically used for prevention and early detection of precancerous lesions caused by the human papillomaviruses (HPV) and can lead to cervical cancer. Often the immune system is able to fight off the virus, and when it does, precancerous lesions tend to regress back to normal cells.
This is why, when precancerous lesions are discovered, the next step is usually to test for HPV. Physicians determine their recommendation for treatment by calculating risk, which depends on the stage of the lesion and whether HPV is still present.
Aggressive treatment usually involves excising the lesion. While this effectively eliminates the risk for developing cancer, it also compromises the cervix and can negatively affect reproductive health, especially if the procedure is done multiple times over a patient’s life.
Treatment According To Race
“Whenever we are able to tailor our treatment accordingly, it’s always the most beneficial approach for our patients," said Dr. Martingano.
He indicated that precancerous lesions in black women seem to take a significantly longer time to progress to a dangerous level. Conversely, Hispanic women who have low-grade lesions and test positive for HPV should probably be treated more aggressively as they worsen the fastest.
“In cases of abnormal cells and low-grade lesions, we have a lot more latitude to give their bodies time to fight the virus and recover on their own. We know different groups of people follow different trajectories in relation to disease progression," said Dr. Martingano.