Cervical cancer is preventable, yet many fail to get screened regularly

He also suggested that women get a separate test for HPV along with their Pap smear; a positive HPV tests means a woman has the virus on her cervix and should be monitored more closely by her doctor. The American Cancer Society says this option is best for women 30 or older, since HPV is so common among younger women and the body usually fights it off.

Pap smears are generally covered by health insurance, and many plans also cover the HPV tests and vaccine. But those without insurance face high costs — about $360 for the vaccine (plus administrative costs, which can raise that figure to $400 or more), about $20-$40 for a Pap smear (plus the charge for the office visit) and $80 to more than $100 for an HPV test.

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However, there are programs that can help women struggling with the costs, including the CDC’s National Breast and Cervical Cancer Early Detection Program, which screens low-income women who are uninsured or underinsured.

Still, some people fall through the cracks. And sometimes, just a few years without screening can spell trouble.

At great risk

Tamika Felder got Pap smears regularly when she was attending college and was still covered by her mother’s health insurance. But when she outgrew that insurance, Felder skipped screenings for three years. She wasn’t too worried when she began having bad menstrual cramps and lower back pain. After landing a full-time job with insurance, she went in for a checkup and got a Pap smear. She could hardly believe the cancer diagnosis and sought several other opinions.

“I was thinking I was in some bad movie,” she said.

Felder said three things would have made a difference for her: being better educated about cervical cancer and its causes, having insurance and not acting as if she were invincible health-wise.

Hilgers said these factors affect many patients. But experts say changing attitudes, getting health messages out to everyone, and improving access to health care are some of the thorniest challenges in medicine.

Krishnan, the New York gynecologist, said she hopes for improvements because the new health-care law should mean fewer uninsured women. “We hope that . . . providing coverage for millions more will reduce the number of cervical cancer cases in this country,” she said.

Hilgers said bringing down the numbers will take a while. “I think we’ve hit a wall in terms of making progress in Pap smears,” he said. “Now, we have to wait for the impact of the [HPV] vaccine. . . . If you immunize today, you’re not going to get a reportable outcome for 10 to 20 years.”

Felder, meanwhile, is doing her part. In 2005, she started a nonprofit group, Tamika & Friends, which seeks to draw attention to cervical cancer and its link to HPV. On May 14 it is sponsoring an awareness walk at RFK Stadium.

“I don’t know if we’ll ever eliminate it completely. But I think we can lower it,” Felder said. “This is a preventable cancer.”

Ungar is the medical writer for the Courier-Journal in Louisville.