Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
The incidence and death rates from cervical cancer have declined over the past 15 years or more. This is partly due to education and partly due to screening for the disease. Nevertheless, there are
still about 15,000 new cases, and 4,500 deaths annually, from this condition in the United States. In developing countries, the rates are much higher. In some countries, cervical cancer is the leading cause of cancer-related death in women.
Most cancers of the cervix (probably about 90%) are of the type known as squamous cell cancer. It is thought that these cancers can be recognized when they are in a very early (or so-called precancerous) condition. At this stage, the disease is localized to the cervix and can be treated relatively easily.
Early treatment has an enormous positive impact on survival in this condition. This is an ideal disease for a screening test. The method used to screen for this disease is the Papanicolaou smear (or Pap smear or Pap test).
The Pap smear is performed by viewing the cervix through a speculum and then using an instrument called an Ayer speculum to gently scrape the surface of the cervix. This leaves a residue of cells on the spatula. These cells are then spread over a microscope slide and fixed with a special chemical. The slides are then viewed under a microscope.
All women who are sexually active, or over age 18 years, should have a regular Pap smear. How regularly they should have these is open to some debate. Most obstetrician-gynecologists (doctors who specialize in women's health) in the United States recommend a Pap test every year. An abnormal result may require more frequent screening.