Did you know that 13,000 women are diagnosed yearly with a preventable and treatable cancer, and one-third of them will die as a result? Cervical cancer is highly preventable in the United States and because of that we can’t help but want to raise awareness about it. Since it is Cervical Health month, we thought we 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 link 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 healthcare 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 twelve 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:
* All women should begin cervical cancer screening at age 21.
* Women ages 21 to 29 should have a Pap test every 3 years. They should not be tested for HPV unless it is needed after an abnormal Pap test result.
* Women ages 30 to 65 should have both a Pap test and an HPV test every 5 years. This is the preferred approach, but it is also OK to have a Pap test alone every 3 years.
* Women over age 65 who have had regular screenings with normal results should not be screened for cervical cancer. Women who have been diagnosed with cervical cancer or pre-cancer should continue to be screened according to the recommendations of their doctor.
* Women who have had their uterus and cervix removed in a hysterectomy and have no history of cervical cancer or pre-cancer should not be screened.
* Women who have had the HPV vaccine should still follow the screening recommendations for their age group.
* Women who are at high risk for cervical cancer may need to be screened more often. Women at high risk might include those with HIV infection, organ transplant, or exposure to the drug DES. They should talk with their doctor or nurse.
* The American Cancer Society no longer recommends that women get a Pap test every year because it generally takes much longer than that, 10 to 20 years, for cervical cancer to develop and overly frequent screening could lead to procedures that are not needed.
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.
If you’d like to be screened for HPV, our Family and Internal Medicine specialists are taking new patients and can be reached at the numbers below: