Symptoms will usually be irregular or increased vaginal bleeding or post coital staining. The precise cause of cervical cancer is not known. Women who have multiple sex partners are at increased risk, and the disease is more frequent in young prostitutes. Those who started intercourse at ages 14 or 15 years have higher risk than those who started intercourse over 20 years. Also, women married to men whose previous wives had developed cervical cancer had threefold increase frequency of the disease. The occurrence of diseases such as gonorrhea has also been shown to be associated with the frequency of cervical carcinoma. Alteration to immune function increases the risk of cancer, i.e. HIV infection. Certain viruses, such as papillomavirus, herpesvirus and cytomegalovirus have also been implicated.

The Pap smear has been widely used for about 50 years to screen women for cancerous and pre-cancerous cervical diseases. It has been effective to reduce the frequency of invasive cancer of the cervix by 50% . However, it is estimated that only 5-12 percent of the recommended target population has ever been screened in our country and those are usually women in the cities). The Pap smear is an office procedure that usually takes only a few minutes. It is done at a time when women are not having menstrual bleeding. A speculum is the instrument used in exposing the cervix, by placing in the vaginal canal. Samples are obtained using cytobrush, spatula or cotton swab. The sample is smeared on a slide and placed in a fixative. The slide will then be interpreted by a pathologist. Usually, in 3-7 days results are released.

The American College of Obstetrics and Gynecology and International Academy of Cytology recommend that Pap smear start at the age of 18 years or when the individual becomes sexually active, and continue annually indefinitely.

There are also newer diagnostic technologies that aim to decrease the false negative (chances of the test being negative when it is actually positive) rate of the conventional Pap smear:

1. Liquid Based Cytology (thin layer technologies)
   • Thin Prep
   • Autocyte
2. Human Papilloma Virus (HPV) Testing
3. Computer Assisted Screening (Screening Automation)

Only the first two diagnostic tests are currently available in most big hospitals.

Again, cervical cancer is preventable and the standard way to screen for the disease is by having an annual pap smear. It is a simple procedure that takes only a few minutes, but can save years in most women lives. Women do not have to wait for symptoms of irregular vaginal bleeding nor post coital staining to have themselves screened for cervical cancer. Even prior to the occurrence of the symptoms, the Pap smear and any of the newer technologies will be able to detect pre-cancerous cells.

Behavior #1: Little Miss Bossy

Why she does it: I recently overheard my 6-year old niece scream at my 4-year old daughter in frustration, “Why do you aways want to get your way? Do you want to rule the world?” To which my daughter replied, “No, I want to be a princess.” While we laughed at this exchange, I had to admit my daughter’s tendency to boss everybody around can be annoying. Preschoolers are naturally power-hungry. They often want what they want and on their terms.

How to stop it: Try laying some ground rules that your child can follow. Always repeat these before social situations so she can be reminded on how to behave. Tell her she has to share her toys or wait for his turn during a play date or a party. Remind her too of the consequences if she doesn’t behave. Finally, reinforce good behavior by praising her whenever you see her cooperating.

Behavior #2: Interrupting conversation

Why he does it: Being rudely interrupted by a demanding child in the middle of a serious conversation is another annoying yet common problem. Most kids insist on immediate attention as they are still trying to master patience. Tugging on your sleeve and interrupting is also a way for your child to make his presence known.

How to stop it: Gary Ezzo, author of the parenting book On Becoming Child Wise, suggests teaching your child to interrupt conversation politely. When your child needs to interrupt, teach him to place a hand on your side, shoulder, or arm and then wait till you acknowledge him. You can then politely excuse yourself from the person you are talking to and give your child your attention. When you’re ready to face your child, you can take his hand and gently squeeze it so he will know that you acknowledge his presence.

Behavior #3: Manipulative Crying

Why he does it: You say “no!” to a request and your preschooler immediately launches into a plaintive howl. These bouts of “no-tears” crying can be one of your child’s most annoying habits. It’s a way for them to test their boundaries — how far they can get away with what they want by getting yur sympathy or annoying you till you give in.

How to stop it: At this stage, children need to learn that crying is not manipulative tool that will get them what they want. Oftentimes, parents need to be aware of what they may or may not be doing to encourage their children’s unwanted behavior. Giving in to a child when he or she is crying to “get something” or to “get out of being disciplined” will only reinforce negative behavior. Instead, remove a child from a negative situation and give him some quiet time to settle down and regroup.

Behavior #4: Nose picking and nail biting

Why he does it: Kids like to explore everywhere, including the little crevices of their bodies. Picking his nose or biting his nails can also be a sign of boredom. Your child doesn’t know what to do with his hands.

How to stop it: Gently pull his hand away from her nose or mouth. Give your child something play with or hold to distract her from doing the habit. Keep your child’s hands busy.

Behavior #5: Kicking and biting when they’re upset

Why he does it: Kicking and biting when your child is in a tantrum is his way of getting attention. It is also a way of expressing their frustration: of not getting what they want or being understood. A violent tantrum can also be triggered by a child’s physical discomfort. She may be hungry, tired or overly stimulated.

How to stop it: When you child resorts to violent tantrums when you say no, don’t give in. Let her know you don’t like it and won’t tolerate it. Stay calm and don’t shout at your child. Hold her tight so she won’t hurt herself or take her somewhere safe where she won’t kick or hit other people. You can try giving her a time out and put her in a corner of the house. Make sure the place is safe and you keep your eyes on your child too. Don’t talk to her till time out is over. After she calms down, find out why she was upset. Explain why you said “no” to what she asked for. Finally, teach your child to express anger the right way: through words. Small kids don’t have enough words to express their emotions and needs so they get frustrated. Be patient and listen. You can tell her that if she cries, kicks, or bites, you won’t be able to understand her.

Behavior #6: Running around (especially in a restaurant or in a church)

Why he does it: Preschoolers are still learning how to control their impulse, which means it can be quite challenging for them to actually stop and keep themselves in check when their feet want to run, for example. But while they are busy discovering and practicing the many skills that they are developing at this age, they need constant and consistent guidance as to how and when to behave in different situations.

How to stop it: The best way to teach children in these instances is to give them creative outlets for their energies. Playing stop and go games, for example, helps them learn how to stop and control their movements within safe, playful context.

Also, instead of just saying “Don’t run,” explain to her that when she runs around in a crowded church, she might bump and hurt other people. Or, in a restaurant, she might get into an accident by bumping into a waiter carrying a loaded food tray.