Preventive Screening: Key to Healthy Lifestyle

Preventive Screening: Key to Healthy Lifestyle

Life in the 90's has created many additional pressures on women, who often must juggle their roles as a worker, a wife and a mother. Stress can sidetrack women from a healthy lifestyle and make them more susceptible to disease. This is why preventive screenings are absolutely necessary-especially when concerning the reproductive system.

"Women should have annual exams beginning at age 18, or the first thought of intercourse," says Mark DeMasi, D.O., assistant professor of obstetrics and gynecology at the University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine, Stratford, N.J. "There is a huge myth that if a woman is not having sexual intercourse then there is no need for a annual exam."

Dr. DeMasi says that annual exams are extremely important for women of all ages because they can detect problems before they become serious. "Many women feel that just because they are young, they can't have cancers or cysts, but that is just not true," he says.

There are three types of major cancers that can affect woman ages 25 to 45. Cervical cancer, Ovarian cancer and Breast cancer strike adult women and all can be detect with regular preventive screenings.

Cervical cancer accounts for 18 percent of all female reproductive cancers. Early detection is key to successful treatment. The best means of detection is a Papanicolou (Pap) smear, which is performed during annual exams. It can identify 90 percent of all cervical cancers.

In some women, healthy cell become abnormal and enter a phase called dysplasia. Although these cell are not cancerous, they can become so. If a dysplastic cell becomes malignant, it will be detected in the carcinoma in situ stage. As the cancer cells multiply, they will invade the lining of the cervix, spread to nearby tissue and enter the bloodstream or lymphatic system. Dysplasia is most likely to occur in woman ages 25 to 35, while carcinoma is situ occurs in women ages 30 to 40.

A Pap smear will detect both dysplasia and carcinoma in situ. When detected early with a Pap smear, cervical cancer is curable. Even in advanced cases the chance of surviving at least five years, with the likelihood of a full cure, is greater than 60 percent. Since 1973, when Pap smears where first introduced, the incidence of death from cervical cancer has decreased more than 40 percent.

Ovarian cancer is the fourth leading cause of cancer deaths in women after lung, breast and colorectal cancer. More women die from ovarian cancer than from all other reproductive cancers combined. Once it has been detected in the body, it is the most lethal form of cancer in women. Annual pelvic exams and physicals are the best screening for this cancer.

The incidence of ovarian cancer rises with age. While half of all cases are detected in women over 60, awareness and early screening can lead to earlier detection. Women can learn if they are at risk for developing ovarian cancer by consulting with their osteopathic family physician. Incidence is highest among white women and lowest among African Americans and Asian. Diet high in fat have been closely linked to ovarian cancer. A family history of ovarian cancer also greatly increased a woman's chance of developing ovarian cancer.

Risks are also greater for women who have no, or few, children or have delayed childbearing until after 35. This is because the longer a woman is exposed to estrogen, their higher the risk for developing ovarian cancer. Childbearing reduces the risk by providing nine-month "breaks" from ovulation during pregnancy, therefore decreasing overall exposure to estrogen. Women who have used infertility drugs also increase their risk for ovarian cancer when used for more than three cycles. Women who take birth control pills have been found to be at lower risk because the lack of ovulation reduces the woman's exposure to estrogen. The longer the women are on the pill, the lower the risk.

According to the American Cancer Society, one in nine women will develop breast cancer at some point in her life. In 1998, 178,700 cases of invasive breast cancer were diagnosed among women in the United States, causing nearly 44,000 deaths. Most of these deaths could have been avoided through regular breast self-exams, routine breast exams performed during annual exams and mammography.

Increasing age is the strongest risk factor for developing breast cancer. The chance of developing breast cancer for a 30-year-old woman is one in 1,000; a 40-year-old woman is one in 300; a 50-year-old woman is one in 150; and a 60-year-old woman is one in 100. Next to age, the strongest risk factor is a family history of breast cancer. Also, woman with no children or who had their first child after age 30 are a higher risk for breast cancer.

Woman should have a baseline mammogram at age 35 and yearly mammograms starting at age 40. Woman who have a family history of breast cancer should have mammograms more often, usually yearly after age 30. Although mammograms offer their best chance for early detection of breast cancer, no test is 100 percent accurate. It is important for women to have annual exams and perform monthly self-breast exams. The earlier the cancer is detected the better the chance for survival.

"We now have the ability to make a woman's life more enjoyable for the future with a little preventive care," says Dr. DeMasi. "Women need to have good awareness and screening to insure a healthy life in the future."

The American Osteopathic Association physicians (D.O.s) are working to raise awareness among women ages 25-45 of the many issues they face as they strive to maintain healthy lifestyles and home preventive care can help maintain good health throughout life. D.O.s, physicians treating people, not just symptoms, are especially well qualified to assist in preventive healthcare since they are fully trained licensed physicians who have additional training that focuses on the body's structure and function, and its ability to heal itself.

The American Osteopathic Association (AOA) urges women to contact their osteopathic family physician for advice on preserving good health for an active lifestyle. Osteopathic physician (D.O.s), physicians treating people, not just symptoms, are especially well qualified to assist in preventive healthcare since they are fully trained licensed physicians who have additional training that focuses on the body's structure and function, and its ability to heal itself. For more information visit the AOA's web site at http://www.osteopathic.org .

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