Annual Pap test, technology saved Los Altos resident’s life

By Shannon Barry, Town Crier Staff Writer

When college student Kristine (who declined the use of her last name) received her first ThinPrep Pap Test in 2003 from Dr. Katherine Sutherland at the Women Physicians OB/GYN Medical Group in Mountain View, results came back normal. But only two years later, her Pap test revealed the presence of low-grade lesions and HPV.

HPV is human papillomavirus, a group of common viruses that infect the skin. Within the last couple of years, it has been recognized as a precursor to cancer.

More than 12,000 cases of cervical cancer are diagnosed in the United States annually – 4,000 result in death. The majority of women diagnosed with cervical cancer never had a Pap test or have gone many years without one.

Kristine is undergoing several procedures to remove the abnormal cells. She said the Pap test diagnosed HPV in the early stages, before she developed cervical cancer, and believes the test saved her life.

“(The test is important) especially for young women. If I hadn’t treated this, I wouldn’t have been able to have kids,” Kristine said. “Not to be able to have kids would have been a very devastating thing for me.”

Sutherland, who has worked in private practice for 25 years, shepherded K through the process, which softened the uncomfortable experience.

Kristine credits communication and annual Pap testing as the keys to her successful treatment.

“(Patients) may not tell their doctors everything and it may be too late by the time they decide to,” Kristine said.

Single women, 18-24, and those without insurance are at the highest risk of developing active HPV, according to the American Social Health Association and the Society of Gynecological Oncologists.

A survey conducted by the American College of Obstetricians and Gynecologists found that 29 percent of the women surveyed haven’t seen a doctor on a regular basis or had a Pap test or mammogram in the past year. And 18 percent of the women surveyed don’t believe Pap tests or mammograms are necessary.

This is a dangerous misconception because the majority of women diagnosed with cervical cancer either have never had a Pap test or had not been tested within five years of the diagnosis.

Although the first HPV vaccine was approved in June 2006, informed women realize regular Pap tests are still important, according to a Lake Research Partners for the American Social Health Association survey of 1,421 women, 18-45, who are aware of the new HPV vaccine.

The new vaccine, approved by the Food and Drug Administration, protects against four strains of HPV that are responsible for 70 percent of cervical cancer cases.

Atherton resident Mary Kelley, 56, was ecstatic when she read about the vaccine. She advised her siblings to have their children vaccinated, but admonished them that an annual test was still necessary.

Kelley was shocked when her test came back abnormal in December 2004 but has used her changed perspective as an opportunity to spread the need for regular screening.

The experience didn’t always come easy, including acceptance.

“The scientist part of me thought it was a fluke,” Kelley recalls, “but six months later the same thing happened and I got scared.”

Kelley, who has lived by herself and not had any sexual partners for 10 years, was surprised at the diagnosis but recognizes abnormal cells can erupt after a period of hibernation.

And if she knew about HPV as a 25-year-old in the ’70s, “I don’t know if I would have made a different choice,” she said. “I believed I was invincible.”

Since the abnormal result, Kelley has gone through several procedures, including a series of cauterizations, burning off abnormal cervical cells using heat, electricity or chemicals.

Staying comfortable throughout the process was difficult, but Sutherland consulted with a gynecologist and found a straightforward hormonal insert treatment, “Vagifem,” that Kelley could use. Since the treatments, Kelley has had three negative Pap smears and is waiting for one more to clear before she is deemed “safe.”

She likens her experience to the black cloud hovering around Charles Schulz’s Linus but is happy it is slowly becoming more transparent.

Jeffrey Young, a physician at the Associated Pathology Medical Group in Los Gatos where Sutherland’s patients – like Kelley – are referred, has seen the positive effects of ongoing Pap test technology.

When the group implemented the ThinPrep Imaging System in 2005, a computerized cervical cancer screening system that scans ThinPrep Pap tests, they immediately noticed improved diagnostic accuracy, Young said.

Before the system was implemented, his company diagnosed approximately 7,000 Pap smears a year. The number has since increased substantially to 30,000.

The system scans the slide, analyzes each cell and has a complex computer algorithm that determines which cells are most abnormal, Young said. Not only are the scans faster than the human eye, but more sensitive and specific.

Young sees it as a GPS system for abnormal cells, and said it is important because “even a good tech can miss abnormal cells.”

Before the system was implemented, screening Pap smears was so tedious even the best biotechnologist error rate was 20 percent, Young said. In his lab, 1 percent or 2 percent of tests come back with abnormal cells and 3 percent are atypical each year.

“The Pap test is critical as a means of diagnosing changes in the cells when they’re still in the precancer stage,” Sutherland said.

For women under 30, annual screening is essential, as they have a 50 percent to 80 percent chance of experiencing some stage of the HPV virus. “It’s like brushing your teeth,” Kelley said. “In today’s medical system, you need to be your own strongest advocate.”

For more information or to find a lecture or group, visit www.elcaminoobgyn.com.

Contact Shannon Barry at shannonb@latc.com.