Women s Health Around Christmas

When the year-end approaches as the year winds down, the atmosphere in the consultation room changes a little too. While hearts grow excited with Christmas and year-end gatherings, it is also a time when the things put off this year come to mind. Among them, what most often gets pushed to the back is precisely women's screening. Especially at year-end, I often meet people who took care of their general health checkup but left out only the gynecologic screening. Before greeting the new year, I will calmly organize, as a seasonal check, which screenings to get at what intervals.

Year-end is, unexpectedly, a good time to put screening in order. This is because the national health checkup and national cancer screening set their targets each year based on birth year, and once a year ends, that opportunity disappears. If you keep putting it off, the screening cycle not uncommonly slides by a year.

In the consultation room, every year there are people who come hurriedly at year-end, saying "my screening eligibility was through this year and I forgot." Checking once in advance can avoid this. When recalling the screening you should get this year, check the following together.

• Whether you received this year's national cancer screening eligibility notice
• When your last cervical cancer screening was
• Whether there were symptoms different from usual, such as bleeding, discharge, or abdominal discomfort
• Whether there is a family history of gynecologic cancer

In particular, if you have had symptoms, we recommend getting care regardless of the screening cycle. This is because screening is a selection process targeting those without symptoms, and when there are symptoms a separate diagnostic approach is needed.

Korea's national cancer screening is relatively dense, so if you fall into the target group, it is reasonable to take care of this first. According to guidance from the Korea Disease Control and Prevention Agency and the National Cancer Center, the items directly related to women are operated as follows.

Cervical cancer screening starts with a simple cervical cytology test collecting cells from the cervix. It ends in a short time, but if screening is delayed and the point of detection is pushed back, the treatment process can become complicated, so keeping the cycle is important. However, the cycle of national cancer screening is a minimum recommendation based on the general population with average risk. Depending on family history, lifestyle, or existing test results, there are cases where it is better to look more often, so we recommend setting the interval that fits you through care.

Cervical cancer is known as a cancer that progresses relatively slowly and is good to catch early through screening. So "from when, and by what method" is the key.

The American College of Obstetricians and Gynecologists and the American Cancer Society recommend starting cervical cancer screening from age 21. For ages 21-29, the option of cytology at 3-year intervals is presented, and for 30-65, a method centered on human papillomavirus testing at 5-year intervals. Korea's national screening has a structure providing cytology at 2-year intervals from age 20, so there is a difference in the starting age and method, and this stems from differences in each country's screening system and cost and accessibility.

Cervical cancer is deeply related to human papillomavirus infection, so it helps to understand HPV vaccination and testing along with screening. This part is addressed in more detail in an article organizing HPV and cervical cancer testing and management. If you are confused about the screening results or curious whether additional testing is needed, first inquire about the screening items by chat.

Ovarian cancer has a slightly different character of screening. Because there are often no clear symptoms until it reaches a late stage, it is commonly mentioned as "a cancer hard to detect early," but that does not mean it is recommended that all women regularly screen for ovarian cancer with tumor markers or ultrasound.

The U.S. Preventive Services Task Force, the American College of Obstetricians and Gynecologists, and the Society of Gynecologic Oncology do not recommend routinely performing ovarian cancer screening in women with average risk. This is because applying tumor-marker tests such as transvaginal ultrasound or CA-125 to the entire asymptomatic population did not reduce mortality, and it is reported that, on the contrary, unnecessary surgery may increase due to false positives.

So what is emphasized is symptom awareness. If changes such as persistent abdominal and pelvic pain or bloating, unexplained weight change, or reduced appetite continue, then it is evaluated with examination, transvaginal ultrasound, and tumor-marker testing if needed. If a suspicious mass is seen on transvaginal ultrasound, it is approached in the following flow.

• When the tumor-marker value is raised: after additional imaging such as CT or MRI, surgical treatment is considered as needed
• When the value is normal: the mass's change in size and shape is tracked by transvaginal ultrasound at 3-6 month intervals

In clinical experience, "not letting body signals different from usual pass by" works as more important for ovarian health than screening itself. If pelvic pain or abnormal discharge recurs, refer to the pelvic pain and abnormal discharge item to gauge the timing of care.

In endometrial cancer, the most meaningful warning signal is abnormal bleeding. Uterine cancer can appear as irregular bleeding or discharge different from usual, but in the early stage there may be no symptoms or it may be passed off as nothing.

In particular, bleeding after menopause should not be taken lightly. According to American College of Obstetricians and Gynecologists materials, a considerable proportion of those diagnosed with endometrial cancer are reported to have postmenopausal bleeding. So if there is bleeding again after menopause, it is safe to get care rather than passing it off as "has my period come back?" How to take postmenopausal bleeding is unpacked further in the article that postmenopausal bleeding is not menstruation.

For endometrial evaluation, looking at the uterus and endometrium with transvaginal ultrasound and conducting an internal examination together is the basis. However, since ultrasound alone can miss some cancers, the recommendation has been updated to also consider a biopsy together when bleeding recurs or the endometrium looks thick. That is, imaging and biopsy are used complementarily. There are also forms that do not show well on screening, but in most cases a clue can be found relatively early in the women's precise screening process.

Even if the screening items look many, setting priorities reduces the burden. If you make time at year-end, we recommend organizing them in the following order.

The first priority is confirming whether you are a target of this year's national cancer screening, and cervical cancer cytology. If the eligibility period is through this year, it is good to finish before the year turns.

The second priority is checking the area where you had symptoms. If there were signals different from usual, such as bleeding, change in discharge, or abdominal discomfort, a step of confirming the cause through care, separate from screening, is needed.

The third priority is additional consultation according to risk factors. If you have a family history or are in a period where hormonal change is in progress, it is good to set the screening interval and items that fit you together. In the sense of wrapping up the year, using an age-appropriate check such as life-cycle screening is also a method.

To greet the new year lightly, putting in order the screening you have put off first makes the mind more comfortable. If you are confused about which screening to get or whether your symptoms are a screening target, please feel free to inquire with the button below.

Looking back once at year-end on the health you put off while busy throughout the year is, in itself, a sufficiently meaningful close. We hope you greet a joyful and healthy new year.

Written by: Lee Dong-hee Director · OB-GYN specialist · View medical staff profile

First published December 21, 2023 · Last reviewed May 30, 2026

References: Korea Disease Control and Prevention Agency and National Cancer Center National Cancer Screening Program Guidance (2024), American College of Obstetricians and Gynecologists ACOG Cervical Cancer Screening Recommendation (2021), U.S. Preventive Services Task Force USPSTF Ovarian Cancer Screening Recommendation (2018), American College of Obstetricians and Gynecologists ACOG Postmenopausal Bleeding Evaluation Committee Opinion (2018, 2026)

This article is intended to provide general health information and does not replace individual diagnosis or treatment. If you have symptoms, please consult through an examination.