When I read that almost 13,000 women are diagnosed yearly with a preventable and treatable cancer, and one-third of them will die as a result, I can’t help but want to support raising awareness of it. So, since it is Cervical Health month, I thought I would touch on some of the basics of cervical health, and how it is not just a woman’s issue.
What is cervical cancer?
As most of you are aware, cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer and spread to other areas. Cervical cancer starts in the cells lining the cervix – the lower part of the uterus (sometimes called the uterine cervix), which has two different parts, and therefore, is covered by two different types of cells. The meeting place of these two parts is called the transformation zone and is where most cervical cancers begin.
The cells in the transformation zone don’t just suddenly turn into cancer. The normal cells of the cervix first gradually develop pre-cancerous changes that turn into cancer. Luckily, we have screenings, or Pap tests, that can detect these pre-cancerous cells that can then be treated. In the last 30 years, according to the American Cancer Society, the death rate of cervical cancer has decreased by over 50%, mainly due to the increase of screenings.
What causes cervical cancer?
While not all cervical cancers are linked to the human papilloma virus (HPV) it is the most common cause. HPV is a large group of related viruses that are segmented into low-risk and high-risk types. The low-risk types tend to cause warts internally and externally on male and female reproductive organs and areas around them. They rarely cause cancer and, therefore, are considered low-risk.
High-risk types of HPV have been linked to cancer in both men and women. Doctors worry about the changes and pre-cancers linked to these types of HPV because they are more likely to cause cancer over time. They have also been linked to vulvar, penile, anal, vaginal, and mouth and throat cancers.
How is HPV contracted?
HPV can be passed along from one person to another by skin-to-skin contact with an infected part of the body, most often through sexual contact. Often times there are no signs or symptoms of the virus for months, years, or ever, once contracted.
Can HPV be prevented?
One the most amazing advances in recent health care is the ability to prevent HPV related cancers by the HPV vaccination. According to the Centers for Design Control, all children who are 11 or 12 years old should get two shots of the HPV vaccine six to 12 months apart. A three-dose series is recommended for adolescents who receive two shots less than five months apart, kids 14 years or older, and those with certain immunocompromising conditions aged 9 to 26.
Other preventative measures recommended by the American Cancer Society for women include:
- Women should begin cervical cancer screenings at age 21. Women aged 21 to 29, should have a Pap test every 3 years. HPV testing should not be used for screening in this age group (it may be used as a part of follow-up for an abnormal Pap test).
- Beginning at age 30, the preferred way to screen is with a Pap test combined with an HPV test every 5 years. This is called co-testing and should continue until age 65.
- Another reasonable option for women 30 to 65 is to get tested every 3 years with just the Pap test.
- Women who are at high risk of cervical cancer because of a suppressed immune system (for example from HIV infection, organ transplant, or long term steroid use) or because they were exposed to DES in utero may need to be screened more often. They should follow the recommendations of their health care team.
- Women over 65 years of age who have had regular screening in the previous 10 years should stop cervical cancer screening as long as they haven’t had any serious pre-cancers found in the last 20 years. Women with a history of serious pre-cancers should continue to have testing for at least 20 years after the abnormality was found.
- Women who have had a total hysterectomy (removal of the uterus and cervix) should stop screening, unless the hysterectomy was done as a treatment for cervical pre-cancer (or cancer). Women who have had a hysterectomy without removal of the should continue cervical cancer screening according to the guidelines above.
- Women of any age should NOT be screened every year by any screening method.
- Women who have been vaccinated against HPV should still follow these guidelines.
- Additionally, men and women, both, are advised to consider abstinence, safe sex (such as condoms), and avoid having many sexual partners to prevent infection.
While these guidelines lay the foundation for cervical health, you should always discuss all options with your healthcare team.
— Tammy Osborn is an Advanced Nurse Practitioner with Blue Springs Internal Medicine. She can be reached at 816-228-9841.