Cancer of the uterine cervix is the third most common gynecologic cancer diagnosis in the United States. The cervix is the neck of the uterus, or the lowest part of the uterus, sitting on top of the vagina. Due to cancer, cells of the cervix become abnormal and grow out of control and invade surrounding organs. The good news is that the rate of cervical cancer has declined significantly due to widespread use of Pap smear screenings, HPV vaccines and the availability of treatment of precancer.
Keep reading to learn more about causes and risk factors for cervical cancer, its symptoms, diagnosis, available treatments and most importantly, strategies for prevention.
Human Papilloma Virus (HPV) infection causes virtually all cases of cervical cancer (found in 99.7 % cases of cervical cancer). It is a sexually transmitted infection which often shows no symptoms, which is why regular screening is so important.
Risk factors for cervical cancer, which are similar to the risk factors for HPV infection, are:
> Early onset of sexual activity (< 18 years)
> Multiple sexual partners
> History of sexually transmitted infections (e.g. chlamydia trachomatis, genital herpes)
> Immunosuppression (lowered immunity, such as HIV infection)
Most HPV infections are transient, meaning they last for only a short time, and the virus alone is not enough to cause cervical precancer or cancer. Among the 40 genital types of HPV, 15 types are responsible for cervical cancer. Most women clear HPV infections by self-immunity over a few years. When HPV infection does persist, the time from initial HPV infection to development of precancer and invasive cancer takes an average of 15 years.
> Early cervical cancer is mostly asymptomatic, meaning it does not show any symptoms, and are mostly found by a Pap smear screening and further testing.
> Common symptoms could include heavy /irregular periods and/or vaginal bleeding after sex.
> A final diagnosis is made by performing a biopsy.
Cervical cancer can be treated by several different methods. Depending on the stage of cancer, treatment could include surgery, radiation and/or chemotherapy.
The good news about cervical cancer is that there are ways to prevent it altogether or catch it in early stages. Getting the HPV vaccine is the best way to prevent cervical cancer, as well as HPV-related anal cancer, cancer of the vulva-vagina and cancer of the penis. The best detection method is getting a Pap smear and an HPV test.
The HPV vaccine works best when it is given before a person gets infected with HPV. Thus, it is important to get the HPV vaccine before becoming sexually active, although it is still beneficial if given to sexually active individuals. The individual will receive 3 doses over a 12-month period.
Age of administration:
> Girls: Ideal age: 11-12 years, but can start as early as 9 years and can be given up to age 26.
> Boys: Ideal age: 11-12 years, but can start at age 9 and can be given up to age 21.
The HPV vaccine does not prevent 100 percent of HPV-related cancers. That’s why it is important to get Pap smears even if one has had the HPV vaccine.
Pap Smear Screening and Treatment of Precancer
A pap smear can detect abnormal cells in the cervix way before it becomes cancer. A pap smear is a screening test and, if it is abnormal, will be followed by diagnostic testing such as colposcopy and biopsy of the cervix. A biopsy can diagnose cervical precancer or cancer.
Pap Smear Recommendations:
> Younger than 21 Years: No pap smear needed.
> 21 -30 years: Pap smear and HPV testing every 3 years if normal.
> 31-64 years: Pap smear with HPV testing every 5 years or Pap smear only every 3 years if normal.
> 65 years or older: Pap smear is not needed if three normal pap smears in a row or two normal Pap/HPV co-testing in a row over the last 10 years or if patient has had a hysterectomy with cervix removed and no abnormal pap smear.
Talk to your physician about the HPV vaccine and which screenings are right for you. If you have children, discuss the HPV vaccine with their pediatrician. For cervical cancer screenings or more information about HPV, call 254-618-1060 to set up an appointment with a women's nurse practitioner.