Apr
28
2013

New Pap Screening Guidelines

Wait...I don't need a pap every year anymore?

New Pap Screening Guidelines

Used to be, getting a pap was your yearly routine. But things have changed. Have you tried to book an appointment lately? You may have noticed some policy changes at your doctor’s office. And these changes are causing a fair bit of confusion.

On our YMC Facebook page recently, a member asked: Why do women now have to wait 3 years to get a pap done? Why is this service no longer available during an annual physical?

Are you wondering the same thing? Well, here’s the deal.

First of all, nobody is disputing the importance of pap smears. Paps can diagnose cervical cancer—and its precursors—at a very early stage, with plenty of time to treat and cure the disease. There is no doubt Paps save lives. But...in this case, there is such a thing as too much of a good thing.

After much international research, it seems that starting paps at a young age, and repeating them frequently, is unnecessary. And the danger of overdoing it with a screening technique means that you’re going to unearth many more borderline abnormal results than you otherwise would. Which means a lot of women have unnecessarily been subjected to colposcopy and interventions like cryotherapy and cervical biopsies that carry the potential for harms like bleeding, pain, and discharge. Worse, they may increase the risk of early loss of future pregnancies or premature labour. Not to mention all the anxiety caused by those false alarms.

Thing is, we’ve probably been overdoing this pap thing for a while now. Many other countries around the world (European countries, in particular) have been doing less frequent testing for quite some time and have achieved the same reductions in cervical cancer rates as we have in Canada.

The recent reduction in pap frequency in Canada is consistent with current research findings, and it’s also in line with what most developed countries are doing. For example:  

  • The UK has a recommended policy of not starting paps until over the age of 25, and only every 3 years.
  • The US recommendations? Every 3 years, over the age of 21.
  • Australia currently recommends doing screening paps every 2 years, but this is possibly set to change.

Screening guidelines in Canada are determined at the provincial level, but all of the provinces are heading in the same direction. Here’s a sampling:

Ontario

Cancer Care Ontario now recommends (as of Aug 2012) that cervical cancer screening start at age 21 and continue every three years until age 70 for all women who are, or ever have been, sexually active.

Alberta

Pap screening is advised to start at age 21, if sexually active, and continue every three years until age 70.

British Columbia

Women should start having pap tests at age 21 or 3 years after first sexual contact. Pap tests should be done every year for the first 3 years; then continue every 2 years if results are normal.

As I was looking at Alberta’s guidelines, I came across an info sheet for patients produced by Alberta Health Services that I thought offered a pretty clear explanation. So here it is, excerpted directly:

  • Most cervical cell changes are caused by infections with certain types of the human papillomavirus (HPV).
  • These types of HPV are spread by sexual contact.
  • HPV is common and spreads so easily that over 70% of people will get HPV in their lifetime.
  • Most people don’t even know when they have HPV because there are usually no symptoms.
  • The immune system will usually clear the HPV within 2 years.
  • When the virus does not clear, it can cause cell changes that may lead to cervical cancer. These changes happen slowly.
  • By getting Pap tests at least once every 3 years, cervical cell changes can be found early and if needed, treated so that cancer does not develop

As with many things, as we research more and understand more, and start to take into consideration the nuances of what we’re doing...we modify our approaches, and revise our recommendations.

If there’s one thing I’ve learned, you can be sure this will not be the last word on this subject. Things will change with these recommendations, as with everything that has to do with the incredibly complex human body and our even more complex disease processes.

It’s a sticky issue, however, because these guidelines are based on population-based research. Which means they’re looking at what’s best for the population, as a whole. There will always be individual cases that fall outside these averages. But how can you make guidelines for an entire population if you take into account every individual possibility? No easy answers there.

So, tell me: do you get regular paps done? What do you think of the new guidelines?

Apr
19
2013

5 Natural Ways To Cope With Seasonal Allergies

put the spring back in your step...

5 Natural Ways To Cope With Seasonal Allergies

It’s spring! Which means: warm winds, tulips, the beginning of baseball season, swingy dresses, itchy eyes and nonstop sneezing...wait. What?

Yes, for some of us, spring is not all butterflies and rainbows. If you suffer seasonal allergies—commonly called hayfever—read on for tips on how to survive (and enjoy) the season.

1. Check pollen counts

The Weather Network produces a daily pollen index for cities across Canada, making it really easy to check each day. If it’s going to be a high pollen day, plan your activities accordingly. Outdoor activities and exercise should be put off until another day—or at least until the end of the afternoon (when pollen counts tend to go down). Windy, low humidity days have the highest pollen index, and rainy days are when you get a break: rain washes pollen away.

2. Shower at bedtime

Most of us shower in the morning...but the trouble is, pollen collects on your hair throughout the day. So if you go to bed like that, pollen rubs off on your pillow while you sleep. Which means, you'll be rolling around—literally—in a bed of pollen all night, and smothering your face in allergens. This is a recipe for waking up with a serious case of the puffies. Shower at night, just before bed, to remove all the offending allergens and ensure a nice, clean, pillow to sleep on.

3. Close the windows

It’s a little heartbreaking, I know, after waiting all winter long to throw open the windows and let the fresh air in. But pollens ride in with all that “fresh” air...so you’re not doing yourself any favors if you’re allergic. This goes for car windows, too.

4. Use a clothes dryer, not an outdoor line

I hear you, it’s not very green of me...and my friend and fellow blogger Gwen Leron might be none too pleased to read this recommendation of mine. But the problem is: pollen can gather on clothes, towels, and sheets that are flapping romantically in the breeze. Not so romantic when your eyes are all red and you’re living on Benadryl.

5. Remove your shoes at the front door 

Same principle as above. Removing your shoes at the door will decrease the pollen you track into your house.

You may not be able to entirely stop your allergy symptoms, but if you follow these steps, you can certainly minimize them. Hope springs eternal, anyway. Har, har. 

Apr
15
2013

Keys To Happiness: Nurturing Friendships

Is a circle of friends more important than a network of relatives?

Keys To Happiness: Nurturing Friendships

I don’t know about you, but it always takes me several attempts, and multiple back-and-forth text messages, to finalize a date with girlfriends. It’s difficult, isn’t it? We’re all busy; we all have competing demands. But I always find, in the end, it was absolutely worth the effort.

And science backs this up. Many studies have shown the health benefits of strong social relationships. In particular, A recent study showed that people in their 40s with a wide circle of friends have a greater sense of well-being than those without close friendships.

They found the more frequently people meet up with their friends, the greater the benefit. And numbers appear to count, here: a wider circle of friends translated to better reported well-being in this study.

(As a side note, the researchers behind this study called these ages "mid-life" which I, for one, staunchly refuse to do. Having recently turned 40 myself I will probably never consider myself middle-aged. Never. I know, I can do the math. But I think I’ve decided that middle age will always remain the future, no matter how old I am.)

Now, I must say, I'm not hugely surprised at the finding that friendships are beneficial to health and happiness. It’s one of our key happiness behaviours (see why gratitude boosts happiness, and why kindness improves your health).

However, one interesting outcome of this study was that, for women, it wasn't as beneficial to have a wide network of family members as it was to have friends. For men, in contrast, it was a good thing to have plenty of close relatives around, in addition to friends.

One theory? In a family network, women traditionally play an obligatory caregiving and nurturing role. Which is, let's face it, not as restful as it could be. Being the caregiver can be satisfying, but it’s hard damn work. In contrast, friends tend to be more supportive of a woman's own choices. And won't depend on her, say, to make them a sandwich.

Still, there’s little doubt about the health benefits of friendships and social connections. For further proof, we can look to three of the communities with the longest-living people in the world: Sardinia, Italy; Okinawa, Japan; and Loma Linda, California. In 2005 National Geographic identified five things they each have in common. At the top of the list: “Put family first” and “Keep socially engaged.” (The other three, incidentally: don’t smoke, stay physically active, and eat a plant-based diet.)

Of course it's difficult, in our busy lives, to squeeze in time for friends. But the extra effort is always worth it. And now you’ve got validation that nurturing your friendships is an investment in your mental health.

For middle age.

Should you ever hit that.