June 5, 2023 • 25 mins
In this episode of the Community Check-In, Dr. Angel Kerney, board-certified obstetrician-gynecologist (OB-GYN) and medical director at Excellus BlueCross BlueShield dives into the significance of preventive screenings, focusing on cervical cancer. By emphasizing the benefits of early detection and treatment, Dr. Kerney provides valuable insights and encourages individuals to prioritize their healthcare needs.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:03):
Welcome to excel Us Blue Cross BlueShields Community check In. Each week we
cover a specific topic featuring excel UsBlue Cross Blue Shield experts. You'll get
to know our team as we discussthe latest in healthcare, health education,
and community health. Find us atexcel Us BCBS dot com and follow on
(00:25):
Instagram and Facebook. Hi am Joelomonico, and welcome to the check in this
week. Today we are talking withdoctor Angel Kearney about the importance of preventative
screenings, specifically in this week's episode, for cervical cancer, which typically shows
no signs or noticeable symptoms, butis detectable and treatable when diagnosed early.
(00:47):
Doctor Kearney, Welcome to the Communitycheck In. It's a pleasure to meet
you. Thank you. It's apleasure to be here. Doctor Kearney is
a Board certified obstetrician and Guide Ecologist, a Fellow of the American College of
Obstetrics and Guidecology, and medical rectorof Excelist Blue Cross Blue Shield And today
we do want to talk about acervical cancer. We will get to that
in just a moment, but I'dlike to start with a broader topic of
(01:07):
conversation. One that we've had withother guests on our program referring to other
cancers, and that is the importanceof screenings. But sometimes screenings don't get
done. The last few years havedefinitely been an unusual situation where people getting
out of regular routine. So doctorfirst, tell us about in your practice
(01:30):
and in your work, why weneed to be reminding people about these very
vital screenings that they should be gettingon a regular basis. Now, as
you previously mentioned, cervical cancer isnot only preventable if it's caught early,
but it can be cured and managed. And there's been a dramatic decline in
(01:52):
cervical cancer diagnoses and deaths over thepast fifty years, and that's a direct
result of higher screening rates. Andthis is why routine exams and screenings are
so important. This is your opportunityto have any disease, any disease to
be detected early when you participate inthe screening, and the earlier you detected
(02:15):
disease, the more effective the treatmentwill be. With cervical cancer in particular,
it typically has no signs or symptomsin the early stages, So when
you neglect the screening, you missyour window of opportunity for early detection and
treatment, which can be life savingand also if detected early. Cervical cancer
(02:38):
is one of the most successfully treatablecancers, so it's important that we remind
our communities and your listeners to stayup to date with screening. Most of
the cervical cancer cases are found inpeople who have never had screening or who
are behind in their screening. Forinstance, during the pandemic, many people
(03:01):
missed routine screening appointments, so it'svery important to remind everyone that routine checkups
and screening are very important to youroverall health. I think the real point
that we'll be talking about a lotthroughout the course of our conversation is just
getting back into the habit of havingregular conversations with your doctor. Or maybe
(03:21):
maybe that's cart before the horse.Maybe for some people it's even finding the
resource to get a primary care doctoror an OBGYN to be able to start
having those conversations about what your baselineof health is today and how you can
continue to watch it and manage it. And you know, as a result
of the pandemic and people skipping ormissing their important screenings, the pandemic has
(03:47):
reduced screenings not only for cervical cancer, but for breast cancer, for colon
cancer as well, And so theconcern is that fewer cancers may have been
and detected while they were still inthe early stages because the screening was missed
during the pandemic. And again,you know, cancers detected early are more
(04:10):
are going to be more likely tobe successfully treated when compared to those diagnosed
in the later stages. And youknow, many people got caught up on
screenings, you know, at alater date, But overall, the COVID
nineteen pandemic still has the screening ratesdown from what they were. So we're
hopeful that most people by now havealready rescheduled their appointments and completed their screening.
(04:33):
And you know, you need tounderstand and be patient that you may
have to wait a little longer toget an appointment because of the backlog,
but don't let that deter you,or get on the schedule and get screened.
And the entire medical community is goingto be watching very closely to see
if there's been any rise in thenumber of cervical cancer diagnoses or if outcomes
(04:57):
have worsened due to the pandemic.I know you don't have a crystal ball,
but we'll throw this out there anyways, when do you suspect the medical
community might start to see some statisticallysignificant data when it comes to these outcomes
when it comes to diagnosis, Isuppose it's probably too early to notice any
real changes in the numbers of instancesof say, reported cervical cancers or any
(05:19):
types of cancers. It may bejust too early. Correct. Yes,
and I don't have a crystal ball, but I think that you should give
the science the same amount of timethat we gave the virus. So you
know, if the virus was goingon one to two years, you know,
give us one to two years toresearch what went on during that time,
(05:39):
and then you know, hopefully they'llhave some data to tell exactly how
this pandemic affected screening. The screeningfor cervical cancers. In fact, the
screenings from many cancers there are relativelyI don't want to say simple process,
because nothing when it comes to tomedical diagnosis or applying the science simple when
(06:00):
you get into the weeds of it. But it really is a relatively easy
process from a patient standpoint to getthat test done correct and screening for cervical
cancer is done in your doctor's office, and I want to stress that it
is done as a part of yourannual GYN or well woman examination. It's
(06:24):
not instead of Okay, So there'stwo screening tests which help in the early
detection of cervical cancer. The firstis called the PAP smear and the second
is called high risk HPV testing.Now HPV stands for human papalomavirus, and
(06:44):
I will explain that in terms thatyou know everyone can appreciate shortly. But
both screening tests, the PAP smearand the HPV test, can both be
performed at the same time using thesame say bole, and both tests are
done in your doctor's office and onlytake a few minutes. So there may
(07:05):
be some listeners who have never hada papsmeir before, some younger viewers if
we have them, So, youknow, I just want to go back
and just explain exactly what is apap smeir, how is it done,
what can they expect, and basicallywhat they expect during a PAPS mirror,
You'll you'll undress, You'll lie downon an exam table with your knees bent,
your heels will be rested in somethingthat we call stirrups, and the
(07:29):
doctor will gently insert a speculum almostlooks like a little duck bill okay,
And once they get it in tothe vagina, they will slowly open it
up so they can visualize your cervix. And your cervix is located at the
very top of the vagina. Okay. So the actual PAPS mirror is when
the doctor takes a tiny brush andbrushes off a sample of cells from your
(07:55):
cervix. Now, those cells aregoing to tell your doctor whether you currently
have any abnormal cells on your cervixthat might need further evaluation. And this
is a topic that I really wantto make sure that the viewers or the
listeners understand, and that is manypeople mistakenly think that anytime a speculum is
(08:20):
inserted into the vagina that a PAPsmeir is being done, and that is
not true. Okay. Pap smearsare not done, for instance, in
the emergency room if you go inthere and you're evaluated for other issues such
as vaginal bleeding, vaginal discharge,pelvic pain. So if you have had
(08:41):
a pelvic exam that was not partof your annual well, woman exam,
you must still follow up with yourdoctor for your routine cervical cancer screening.
I've had so many patients say,oh, yeah, I had a pap
smeer in the emergency room last year, and it's like, no, they
(09:01):
don't do those in the emergency room. And they actually thought that that was
their screening. So that's a veryimportant message to get across. So again,
the actual pap smere is when thedoctor takes a tiny brush rushes off
the sample of cells from your cervixas a screening test specifically for cervical cancer.
Now, with that being said,I want to talk about the human
(09:24):
papaloma virus. And you know,other than being a big scary word that
most people can't pronounce, will justcall it HPV. So HPV is a
virus that can increase your risk ofdeveloping cervical cancer in the future. Okay,
And there's many different types of thisvirus, but the ones that we
(09:46):
are particularly concerned about our types sixteenand eighteen because those are the types that
are called the high risk HPV andthese types can actually increase your risk of
develop looking cervical cancer in the future. Now, when you have hp HPV
testing done, It's important to rememberthat this is a screening test. The
(10:09):
HPV test will not tell your doctorthat you have cervical cancer. It will
tell your doctor that you have thetype of HPV that can increase the chances
of cervical cancer in the future.Okay, so the paps MIRRA will tell
you if you have abnormal cells rightnow. The HPV test tells you your
(10:31):
risk of having you know, cervicalcancer in the future. So knowledge is
power, and this is why screeningis so important because once you have knowledge
of your risk, you and yourdoctor can decide what the next steps should
be and depending on your results,there are several things that your doctor may
(10:52):
recommend normal monitoring with the recommended screeningschedule, which will discuss later. Something
called called oscope which many have heardof, which is an office procedure where
a magnifying device is used to moreclosely examine the cervix. Often there can
be a biopsy of the cervix involved, where the doctor will remove tiny tissue
(11:13):
samples from the cervix for evaluation.And also there's various procedures that can destroy
or remove the abnormal cells. Sothose are just some of the things that
can occur depending on what your testresults show. This is the Community check
In with Excellless Blue Cross Blue Shield, and today we are talking with our
(11:33):
guest doctor Angel Kearney about the importanceof preventative screenings and we're especially focusing on
cervical cancer on this week's community checkin. Many things to unpack in in
what we just talked about there.I want to talk just for a brief
moment about patient advocacy. When youmentioned that the pap smere is done as
(11:54):
part of a regular ob gyn orgynecological well visits that a woman would have
every single year, and some mightthink, oh, well, I had
some other procedure or some other testsdone. How important is it for a
patient to just request something or canthey do that if they're going in for
something else saying, look, aslong as I'm having this, I would
like to have this additional screening.Is that something they can do to advocate
(12:16):
for themselves, something I would recommend, Like in an emergency room setting,
you want to have screening done withyour personal physician, that would be the
best place to have the screening donebecause you want all your information in one
place so they know they can lookat that and they know exactly what you
(12:37):
had, what you need, whatthe plan is. So I would not
advise going into the emergency room saying, hey, since I'm here, can
you do a pap smere Number one, they're not equipped to do that,
And number two, they probably wouldnot want to do that. They would
tell you follow up, follow upwith your doctor exactly. How sensitive are
the testing methods to be able todo those texans with a very small sample.
(13:01):
It seems like that's a very smallsample size that's being taken with a
routine pap smear. Technology is awonderful thing, and it is certainly advanced
dramatically in the medical field. Howsensitive is the test to be able to
make those accurate assessments to where patientsmay need to go for further study or
for care. I'm very sensitive becausewhat we're doing as obstentrition gynecologists or other
(13:26):
providers is we're just obtaining the cellsfor the sample, and then that gets
sent off to a lab and youhave cytologists who are people who are specialized
in the examination of cells, andpathologists who specialize in the evaluation of tissue,
and those people will look at thosecells and look at that tissue and
(13:50):
make a diagnosis which they then sendback to the physician, and the physician
can use that information to determine treatmentor next steps for the patient. So
you know, us taking the sampleis not really that's specific. It's what
happens when we send that sample offand we get very specific information back in
(14:11):
terms of what they have, andthen we know what to do with it.
Once we receive those reserves, letthe experts put their eyes on it
and then decide nep steps. Notbeing a parent myself, I have not
had to have the conversation with adoctor about HPV when it comes to our
youngsters especially, and I hear thatthere's a vaccine that is available that is
(14:35):
that is part of preventative measures whenit comes to HPV. Not to unpack
a whole lot in the vaccine era, but I'm wondering if you can speak
in sort of general terms about howthat plays into how people start to make
an approach or how people start tomake decisions for healthcare and that being a
factor with it. Yes, nowthe HPV vaccine is available. It is
(15:00):
extremely effective in helping to prevent thecervical cancer development in the future, and
it's offered to kids between eleven andtwelve to begin with, and it's very
effective and it should be given.It's two doses or three doses of the
vaccine, depending on the age thatyou get it. And what I discovered
(15:24):
when I was in practice is thatand this is a known fact that forty
one point nine percent of these kidsare not getting the HPV vaccine as they
should, and a big part ofthat is parntal. And when I was
in my private practice, I spenta lot of time counselating the parents about
(15:45):
this, because if you're eleven andtwelve, you can't make the decision to
get the HPV vaccine and reduce yourrisk of cervical cancer in the future.
You need your parents to bring upthe topic and to tell you about it.
And the problem is that a lotof parents aren't ready at eleven or
twelve to have these types of discussionswith their children, and they feel that
(16:11):
they fear that they might be openinga door a little too early. Then
you know they wanted to open it, because when you're eleven to twelve,
the kids are gonna say, whatis HPV, and well, how do
you get it, well, ohokay, and then you could have been
you know, they're just weirded outabout the entire discussion, and so many
times they just say, an't forgetit. And what I would do with
(16:33):
my patience the adults is I wouldtell them what you don't want to be
is you don't want to be thatparent that the kid comes back to you
with, you know, cervical canceror pre cancer or something and they say,
gee, Mom, you know,gee Dad, I heard there was
a vaccine that I could have beengiven when I was eleven or twelve years
old, and you know, youguys never told me about it, and
(16:57):
had I known, maybe I've wouldbe in this situation right now. And
so it's really important for providers toeducate the parents because we typically don't have
access to children at eleven and twelveyears old in ob GYN, and so
it's really important to educate those parentsso that these children can take advantage of
(17:18):
the vaccine and the decreased risk ofcervical cancer in the future. And while
we're talking about ages, let's talkabout those screening ages. Who should be
screened and when? Okay, allright, So there is so much information
with this cervical cancer screening and itcan become very confusing, and you know,
we certainly understand that, and somy little word of advice is to
(17:42):
just keep it simple and just rememberthe screening outlines for your particular age group.
Okay, and that's where you canstart. And again I'm going to
use this opportunity to remind people thatthe screening does not replace your yearly well
woman exam with your doctor. Okay. The screening exam is a portion of
(18:04):
the well woman exam, and whatthese guidelines are referring to is the portion
of the exam that is the cervicalscreening. Okay. So by keeping your
regular appointments with your doctor, youcan keep informed about your screening needs.
Now you're not out there alone.Nobody's going to walk up to you and
(18:25):
say, hey, recite the cervicalcancer screening guidelines. You know, you
just have to remember the guidelines foryour specific age group and keep your regular
appointments and your doctor will keep youinformed of exactly what you need to do.
Okay. So with that being said, here's the cervical cancer screening guidelines.
And these guidelines are if you havea cervix and you're of average risk.
(18:49):
Okay. Now, if you havea history of abnormal PAP smears,
then your screening is going to besomething different and it's going to be directed
by your physician on an end ofdigital basis. Okay. But if you
just have the average risk and youhave a cervix, the recommendations are as
follows. If you are under theage of twenty one, there is no
(19:11):
cervical cancer screening necessary. Okay.Once you become twenty one to twenty nine,
then PAPS mirrors need to be doneevery three years. Once you're between
age thirty to sixty five, youhave three options. I always say with
age comes options. You can continueto get your PAP smeer every three years,
(19:33):
or if you want to stretch itout to five years, you can
do the HPV test with the PAPsmeer and then you would only need that
every five years, or you coulddo the HPV test only every five years.
And then if you are over theage of sixty five, if your
previous PAPS mirrors have been negative,then no screening is required. If you've
(19:56):
had three PAPS mirrors in the priorten years, or if you've had two
of the path with HPV test inthe prior ten years. And again that's
a lot to remember. But bykeeping your regular appointments, your doctor can
keep you informed of your screening needs. And if you're screening regularly, and
if detection is made because of thosescreenings, then cervical cancer is very treatable.
(20:21):
As you mentioned at the beginning ofthe shred of the program, very
treatable and very curable for the earlystages. So testing and treatment, everything
of that, it works in ourfavors. So why is it that we
don't see every individual who may beeligible to get the screening taking advantage of
the screening. Did you know thatin New York State, twenty percent of
women who are eligible for cervical cancerscreening are not following these screening guidelines,
(20:47):
even though there's so much evidence thatthe screening saves lives and the data shows
that the screening rates vary based onwhere you reside, and so increasing awareness
and schedule your screening appointments are very, very important. So it comes down
to individuals who don't get screened,Individuals who don't take advantage or don't have
(21:10):
these conversations for cervical cancer and othertypes of cancers. When you look at
the population, when you look atour community, where are the biggest risk
factors? What are the community membersthat are at the greatest risk for not
getting good outcomes? Black women andblack women are likely to die from late
stage cervical cancer. They're more likelyto die from late stage cervical cancer than
(21:36):
any other racial or ethnic group inthe United States. And they're one point
five times more likely to die fromcervical cancer than white women, even when
they have the same median income.So if you are an African American listener,
it is super important that you stayon top of your screening guidelines at
(21:57):
all times because your risk is justinherently higher and there's plenty of factors that
could get in the way of that. And before we run out of time,
I want to make sure that peopleunderstand what the resources are. If
you're worried about the cost of thecervical cancer. Most insurances, I mean,
(22:18):
they're going to cover this for preventativescreenings, are they not? Yes,
If you're insured, preventative screenings aregoing to be covered in most cases.
If you're uninsured or underinsured, there'sfree screenings for breast cancer cervical cancer
and colon cancer available through the NewYork State Department of Health, and they're
(22:40):
available in every county and every boroughin New York State. And as you
probably would guess by this point,early diagnosis, early screening, regular screening
can save lives and the percentages aredramatically high. Within our last minute,
here, doctor Kearney, where canfolks get more information if they want to
(23:02):
connect to these resources that are available? Heay to connect for free screening and
support services in your community. Youcan call one eight six six four four
two cancer. You can also findprevention screening guidelines at Excelist, Blue Cross,
Blue Shield by going to www dotexcelist, bcbs dot com forward slash
(23:30):
preventive Care add In our final thirtyseconds, I want you to give your
pitch doctor for early detection and earlytreatment. Early detection and early treatment.
Get on the schedule and get itdone. Make it a priority. You
know, there are so many differentdiseases and cancers that you can get,
(23:52):
and there's not much you can doonce you get them. I mean,
they can treat them the best theycan, but preventing them is another story.
But with cervical cancer, this issomething that can be prevented, managed
and have a very positive outcome ifdetected and treated early. And the only
way that's going to happen is ifyou do screening. Doctor Andrew Kearney is
(24:15):
a Board certified obstetrition and gut ecologist, a Fellow of the American College of
Obstetrics and got Ecology, Medical directorat Excelis Blue Cross, Blue Shield and
if you would like more information,you can find it at excels BCBS dot
com slash Preventive Care. Doctor Kurney, thank you for being a part of
the check in this week, Thankyou for having you, Thanks for joining
(24:36):
us on Community check In, apresentation of Excellis Blue Cross Blue Shield at
iHeartRadio. Podcasts of Community check Inare available on the iHeartRadio app or wherever
you find your favorite audio content.For more ways to stay safe, healthy,
and educated, visit excelus BCBS dotcom and follow on Instagram and Facebook.
Welcome to excel Us Blue Cross BlueShields Community check In. Each week we
cover a specific topic featuring excel UsBlue Cross Blue Shield experts. You'll get
to know our team as we discussthe latest in healthcare, health education,
and community health. Find us atexcel Us BCBS dot com and follow on
(00:25):
Instagram and Facebook. Hi am Joelomonico, and welcome to the check in this
week. Today we are talking withdoctor Angel Kearney about the importance of preventative
screenings, specifically in this week's episode, for cervical cancer, which typically shows
no signs or noticeable symptoms, butis detectable and treatable when diagnosed early.
(00:47):
Doctor Kearney, Welcome to the Communitycheck In. It's a pleasure to meet
you. Thank you. It's apleasure to be here. Doctor Kearney is
a Board certified obstetrician and Guide Ecologist, a Fellow of the American College of
Obstetrics and Guidecology, and medical rectorof Excelist Blue Cross Blue Shield And today
we do want to talk about acervical cancer. We will get to that
in just a moment, but I'dlike to start with a broader topic of
(01:07):
conversation. One that we've had withother guests on our program referring to other
cancers, and that is the importanceof screenings. But sometimes screenings don't get
done. The last few years havedefinitely been an unusual situation where people getting
out of regular routine. So doctorfirst, tell us about in your practice
(01:30):
and in your work, why weneed to be reminding people about these very
vital screenings that they should be gettingon a regular basis. Now, as
you previously mentioned, cervical cancer isnot only preventable if it's caught early,
but it can be cured and managed. And there's been a dramatic decline in
(01:52):
cervical cancer diagnoses and deaths over thepast fifty years, and that's a direct
result of higher screening rates. Andthis is why routine exams and screenings are
so important. This is your opportunityto have any disease, any disease to
be detected early when you participate inthe screening, and the earlier you detected
(02:15):
disease, the more effective the treatmentwill be. With cervical cancer in particular,
it typically has no signs or symptomsin the early stages, So when
you neglect the screening, you missyour window of opportunity for early detection and
treatment, which can be life savingand also if detected early. Cervical cancer
(02:38):
is one of the most successfully treatablecancers, so it's important that we remind
our communities and your listeners to stayup to date with screening. Most of
the cervical cancer cases are found inpeople who have never had screening or who
are behind in their screening. Forinstance, during the pandemic, many people
(03:01):
missed routine screening appointments, so it'svery important to remind everyone that routine checkups
and screening are very important to youroverall health. I think the real point
that we'll be talking about a lotthroughout the course of our conversation is just
getting back into the habit of havingregular conversations with your doctor. Or maybe
(03:21):
maybe that's cart before the horse.Maybe for some people it's even finding the
resource to get a primary care doctoror an OBGYN to be able to start
having those conversations about what your baselineof health is today and how you can
continue to watch it and manage it. And you know, as a result
of the pandemic and people skipping ormissing their important screenings, the pandemic has
(03:47):
reduced screenings not only for cervical cancer, but for breast cancer, for colon
cancer as well, And so theconcern is that fewer cancers may have been
and detected while they were still inthe early stages because the screening was missed
during the pandemic. And again,you know, cancers detected early are more
(04:10):
are going to be more likely tobe successfully treated when compared to those diagnosed
in the later stages. And youknow, many people got caught up on
screenings, you know, at alater date, But overall, the COVID
nineteen pandemic still has the screening ratesdown from what they were. So we're
hopeful that most people by now havealready rescheduled their appointments and completed their screening.
(04:33):
And you know, you need tounderstand and be patient that you may
have to wait a little longer toget an appointment because of the backlog,
but don't let that deter you,or get on the schedule and get screened.
And the entire medical community is goingto be watching very closely to see
if there's been any rise in thenumber of cervical cancer diagnoses or if outcomes
(04:57):
have worsened due to the pandemic.I know you don't have a crystal ball,
but we'll throw this out there anyways, when do you suspect the medical
community might start to see some statisticallysignificant data when it comes to these outcomes
when it comes to diagnosis, Isuppose it's probably too early to notice any
real changes in the numbers of instancesof say, reported cervical cancers or any
(05:19):
types of cancers. It may bejust too early. Correct. Yes,
and I don't have a crystal ball, but I think that you should give
the science the same amount of timethat we gave the virus. So you
know, if the virus was goingon one to two years, you know,
give us one to two years toresearch what went on during that time,
(05:39):
and then you know, hopefully they'llhave some data to tell exactly how
this pandemic affected screening. The screeningfor cervical cancers. In fact, the
screenings from many cancers there are relativelyI don't want to say simple process,
because nothing when it comes to tomedical diagnosis or applying the science simple when
(06:00):
you get into the weeds of it. But it really is a relatively easy
process from a patient standpoint to getthat test done correct and screening for cervical
cancer is done in your doctor's office, and I want to stress that it
is done as a part of yourannual GYN or well woman examination. It's
(06:24):
not instead of Okay, So there'stwo screening tests which help in the early
detection of cervical cancer. The firstis called the PAP smear and the second
is called high risk HPV testing.Now HPV stands for human papalomavirus, and
(06:44):
I will explain that in terms thatyou know everyone can appreciate shortly. But
both screening tests, the PAP smearand the HPV test, can both be
performed at the same time using thesame say bole, and both tests are
done in your doctor's office and onlytake a few minutes. So there may
(07:05):
be some listeners who have never hada papsmeir before, some younger viewers if
we have them, So, youknow, I just want to go back
and just explain exactly what is apap smeir, how is it done,
what can they expect, and basicallywhat they expect during a PAPS mirror,
You'll you'll undress, You'll lie downon an exam table with your knees bent,
your heels will be rested in somethingthat we call stirrups, and the
(07:29):
doctor will gently insert a speculum almostlooks like a little duck bill okay,
And once they get it in tothe vagina, they will slowly open it
up so they can visualize your cervix. And your cervix is located at the
very top of the vagina. Okay. So the actual PAPS mirror is when
the doctor takes a tiny brush andbrushes off a sample of cells from your
(07:55):
cervix. Now, those cells aregoing to tell your doctor whether you currently
have any abnormal cells on your cervixthat might need further evaluation. And this
is a topic that I really wantto make sure that the viewers or the
listeners understand, and that is manypeople mistakenly think that anytime a speculum is
(08:20):
inserted into the vagina that a PAPsmeir is being done, and that is
not true. Okay. Pap smearsare not done, for instance, in
the emergency room if you go inthere and you're evaluated for other issues such
as vaginal bleeding, vaginal discharge,pelvic pain. So if you have had
(08:41):
a pelvic exam that was not partof your annual well, woman exam,
you must still follow up with yourdoctor for your routine cervical cancer screening.
I've had so many patients say,oh, yeah, I had a pap
smeer in the emergency room last year, and it's like, no, they
(09:01):
don't do those in the emergency room. And they actually thought that that was
their screening. So that's a veryimportant message to get across. So again,
the actual pap smere is when thedoctor takes a tiny brush rushes off
the sample of cells from your cervixas a screening test specifically for cervical cancer.
Now, with that being said,I want to talk about the human
(09:24):
papaloma virus. And you know,other than being a big scary word that
most people can't pronounce, will justcall it HPV. So HPV is a
virus that can increase your risk ofdeveloping cervical cancer in the future. Okay,
And there's many different types of thisvirus, but the ones that we
(09:46):
are particularly concerned about our types sixteenand eighteen because those are the types that
are called the high risk HPV andthese types can actually increase your risk of
develop looking cervical cancer in the future. Now, when you have hp HPV
testing done, It's important to rememberthat this is a screening test. The
(10:09):
HPV test will not tell your doctorthat you have cervical cancer. It will
tell your doctor that you have thetype of HPV that can increase the chances
of cervical cancer in the future.Okay, so the paps MIRRA will tell
you if you have abnormal cells rightnow. The HPV test tells you your
(10:31):
risk of having you know, cervicalcancer in the future. So knowledge is
power, and this is why screeningis so important because once you have knowledge
of your risk, you and yourdoctor can decide what the next steps should
be and depending on your results,there are several things that your doctor may
(10:52):
recommend normal monitoring with the recommended screeningschedule, which will discuss later. Something
called called oscope which many have heardof, which is an office procedure where
a magnifying device is used to moreclosely examine the cervix. Often there can
be a biopsy of the cervix involved, where the doctor will remove tiny tissue
(11:13):
samples from the cervix for evaluation.And also there's various procedures that can destroy
or remove the abnormal cells. Sothose are just some of the things that
can occur depending on what your testresults show. This is the Community check
In with Excellless Blue Cross Blue Shield, and today we are talking with our
(11:33):
guest doctor Angel Kearney about the importanceof preventative screenings and we're especially focusing on
cervical cancer on this week's community checkin. Many things to unpack in in
what we just talked about there.I want to talk just for a brief
moment about patient advocacy. When youmentioned that the pap smere is done as
(11:54):
part of a regular ob gyn orgynecological well visits that a woman would have
every single year, and some mightthink, oh, well, I had
some other procedure or some other testsdone. How important is it for a
patient to just request something or canthey do that if they're going in for
something else saying, look, aslong as I'm having this, I would
like to have this additional screening.Is that something they can do to advocate
(12:16):
for themselves, something I would recommend, Like in an emergency room setting,
you want to have screening done withyour personal physician, that would be the
best place to have the screening donebecause you want all your information in one
place so they know they can lookat that and they know exactly what you
(12:37):
had, what you need, whatthe plan is. So I would not
advise going into the emergency room saying, hey, since I'm here, can
you do a pap smere Number one, they're not equipped to do that,
And number two, they probably wouldnot want to do that. They would
tell you follow up, follow upwith your doctor exactly. How sensitive are
the testing methods to be able todo those texans with a very small sample.
(13:01):
It seems like that's a very smallsample size that's being taken with a
routine pap smear. Technology is awonderful thing, and it is certainly advanced
dramatically in the medical field. Howsensitive is the test to be able to
make those accurate assessments to where patientsmay need to go for further study or
for care. I'm very sensitive becausewhat we're doing as obstentrition gynecologists or other
(13:26):
providers is we're just obtaining the cellsfor the sample, and then that gets
sent off to a lab and youhave cytologists who are people who are specialized
in the examination of cells, andpathologists who specialize in the evaluation of tissue,
and those people will look at thosecells and look at that tissue and
(13:50):
make a diagnosis which they then sendback to the physician, and the physician
can use that information to determine treatmentor next steps for the patient. So
you know, us taking the sampleis not really that's specific. It's what
happens when we send that sample offand we get very specific information back in
(14:11):
terms of what they have, andthen we know what to do with it.
Once we receive those reserves, letthe experts put their eyes on it
and then decide nep steps. Notbeing a parent myself, I have not
had to have the conversation with adoctor about HPV when it comes to our
youngsters especially, and I hear thatthere's a vaccine that is available that is
(14:35):
that is part of preventative measures whenit comes to HPV. Not to unpack
a whole lot in the vaccine era, but I'm wondering if you can speak
in sort of general terms about howthat plays into how people start to make
an approach or how people start tomake decisions for healthcare and that being a
factor with it. Yes, nowthe HPV vaccine is available. It is
(15:00):
extremely effective in helping to prevent thecervical cancer development in the future, and
it's offered to kids between eleven andtwelve to begin with, and it's very
effective and it should be given.It's two doses or three doses of the
vaccine, depending on the age thatyou get it. And what I discovered
(15:24):
when I was in practice is thatand this is a known fact that forty
one point nine percent of these kidsare not getting the HPV vaccine as they
should, and a big part ofthat is parntal. And when I was
in my private practice, I spenta lot of time counselating the parents about
(15:45):
this, because if you're eleven andtwelve, you can't make the decision to
get the HPV vaccine and reduce yourrisk of cervical cancer in the future.
You need your parents to bring upthe topic and to tell you about it.
And the problem is that a lotof parents aren't ready at eleven or
twelve to have these types of discussionswith their children, and they feel that
(16:11):
they fear that they might be openinga door a little too early. Then
you know they wanted to open it, because when you're eleven to twelve,
the kids are gonna say, whatis HPV, and well, how do
you get it, well, ohokay, and then you could have been
you know, they're just weirded outabout the entire discussion, and so many
times they just say, an't forgetit. And what I would do with
(16:33):
my patience the adults is I wouldtell them what you don't want to be
is you don't want to be thatparent that the kid comes back to you
with, you know, cervical canceror pre cancer or something and they say,
gee, Mom, you know,gee Dad, I heard there was
a vaccine that I could have beengiven when I was eleven or twelve years
old, and you know, youguys never told me about it, and
(16:57):
had I known, maybe I've wouldbe in this situation right now. And
so it's really important for providers toeducate the parents because we typically don't have
access to children at eleven and twelveyears old in ob GYN, and so
it's really important to educate those parentsso that these children can take advantage of
(17:18):
the vaccine and the decreased risk ofcervical cancer in the future. And while
we're talking about ages, let's talkabout those screening ages. Who should be
screened and when? Okay, allright, So there is so much information
with this cervical cancer screening and itcan become very confusing, and you know,
we certainly understand that, and somy little word of advice is to
(17:42):
just keep it simple and just rememberthe screening outlines for your particular age group.
Okay, and that's where you canstart. And again I'm going to
use this opportunity to remind people thatthe screening does not replace your yearly well
woman exam with your doctor. Okay. The screening exam is a portion of
(18:04):
the well woman exam, and whatthese guidelines are referring to is the portion
of the exam that is the cervicalscreening. Okay. So by keeping your
regular appointments with your doctor, youcan keep informed about your screening needs.
Now you're not out there alone.Nobody's going to walk up to you and
(18:25):
say, hey, recite the cervicalcancer screening guidelines. You know, you
just have to remember the guidelines foryour specific age group and keep your regular
appointments and your doctor will keep youinformed of exactly what you need to do.
Okay. So with that being said, here's the cervical cancer screening guidelines.
And these guidelines are if you havea cervix and you're of average risk.
(18:49):
Okay. Now, if you havea history of abnormal PAP smears,
then your screening is going to besomething different and it's going to be directed
by your physician on an end ofdigital basis. Okay. But if you
just have the average risk and youhave a cervix, the recommendations are as
follows. If you are under theage of twenty one, there is no
(19:11):
cervical cancer screening necessary. Okay.Once you become twenty one to twenty nine,
then PAPS mirrors need to be doneevery three years. Once you're between
age thirty to sixty five, youhave three options. I always say with
age comes options. You can continueto get your PAP smeer every three years,
(19:33):
or if you want to stretch itout to five years, you can
do the HPV test with the PAPsmeer and then you would only need that
every five years, or you coulddo the HPV test only every five years.
And then if you are over theage of sixty five, if your
previous PAPS mirrors have been negative,then no screening is required. If you've
(19:56):
had three PAPS mirrors in the priorten years, or if you've had two
of the path with HPV test inthe prior ten years. And again that's
a lot to remember. But bykeeping your regular appointments, your doctor can
keep you informed of your screening needs. And if you're screening regularly, and
if detection is made because of thosescreenings, then cervical cancer is very treatable.
(20:21):
As you mentioned at the beginning ofthe shred of the program, very
treatable and very curable for the earlystages. So testing and treatment, everything
of that, it works in ourfavors. So why is it that we
don't see every individual who may beeligible to get the screening taking advantage of
the screening. Did you know thatin New York State, twenty percent of
women who are eligible for cervical cancerscreening are not following these screening guidelines,
(20:47):
even though there's so much evidence thatthe screening saves lives and the data shows
that the screening rates vary based onwhere you reside, and so increasing awareness
and schedule your screening appointments are very, very important. So it comes down
to individuals who don't get screened,Individuals who don't take advantage or don't have
(21:10):
these conversations for cervical cancer and othertypes of cancers. When you look at
the population, when you look atour community, where are the biggest risk
factors? What are the community membersthat are at the greatest risk for not
getting good outcomes? Black women andblack women are likely to die from late
stage cervical cancer. They're more likelyto die from late stage cervical cancer than
(21:36):
any other racial or ethnic group inthe United States. And they're one point
five times more likely to die fromcervical cancer than white women, even when
they have the same median income.So if you are an African American listener,
it is super important that you stayon top of your screening guidelines at
(21:57):
all times because your risk is justinherently higher and there's plenty of factors that
could get in the way of that. And before we run out of time,
I want to make sure that peopleunderstand what the resources are. If
you're worried about the cost of thecervical cancer. Most insurances, I mean,
(22:18):
they're going to cover this for preventativescreenings, are they not? Yes,
If you're insured, preventative screenings aregoing to be covered in most cases.
If you're uninsured or underinsured, there'sfree screenings for breast cancer cervical cancer
and colon cancer available through the NewYork State Department of Health, and they're
(22:40):
available in every county and every boroughin New York State. And as you
probably would guess by this point,early diagnosis, early screening, regular screening
can save lives and the percentages aredramatically high. Within our last minute,
here, doctor Kearney, where canfolks get more information if they want to
(23:02):
connect to these resources that are available? Heay to connect for free screening and
support services in your community. Youcan call one eight six six four four
two cancer. You can also findprevention screening guidelines at Excelist, Blue Cross,
Blue Shield by going to www dotexcelist, bcbs dot com forward slash
(23:30):
preventive Care add In our final thirtyseconds, I want you to give your
pitch doctor for early detection and earlytreatment. Early detection and early treatment.
Get on the schedule and get itdone. Make it a priority. You
know, there are so many differentdiseases and cancers that you can get,
(23:52):
and there's not much you can doonce you get them. I mean,
they can treat them the best theycan, but preventing them is another story.
But with cervical cancer, this issomething that can be prevented, managed
and have a very positive outcome ifdetected and treated early. And the only
way that's going to happen is ifyou do screening. Doctor Andrew Kearney is
(24:15):
a Board certified obstetrition and gut ecologist, a Fellow of the American College of
Obstetrics and got Ecology, Medical directorat Excelis Blue Cross, Blue Shield and
if you would like more information,you can find it at excels BCBS dot
com slash Preventive Care. Doctor Kurney, thank you for being a part of
the check in this week, Thankyou for having you, Thanks for joining
(24:36):
us on Community check In, apresentation of Excellis Blue Cross Blue Shield at
iHeartRadio. Podcasts of Community check Inare available on the iHeartRadio app or wherever
you find your favorite audio content.For more ways to stay safe, healthy,
and educated, visit excelus BCBS dotcom and follow on Instagram and Facebook.
Popular Podcasts
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com