This month we want to bring awareness to what cervical cancer is, how to prevent it, and how to detect it. Cervical cancer is a very preventable and treatable cancer because of today’s screenings and vaccines. If you haven't had a pap smear or HPV test recently, there's no better time than now, given that January is Cervical Cancer Awareness Month. Cervical cancer is a slow growing and highly preventable and curable form of cancer that occurs when cells from the cervix grow abnormally within other tissues and organs outside of the cervix.
What are the risk factors for cervical cancer?
Like all cancers, there are many risk factors that can increase the likelihood of developing cervical cancer. Almost all cervical cancers are caused by HPV, a common virus that can be passed from one person to another during sex. Both men and women can have HPV. For most women, HPV will go away on its own, however, if it does not, there is a chance that over time it may cause cervical cancer. Other things that can increase your risk of cervical cancer include having HIV or another condition that makes it hard for your body to fight off health problems, smoking, using birth control pills for a long period of time, if you have given birth to three or more children, and having several sexual partners. These are the most common risk factors for developing cervical cancer; however, it is hard to limit one factor as the main cause. Many women with these risks will not develop cervical cancer, but it is important to monitor the risk factors.
What can I do to reduce my risk?
Screenings
The most important thing you can do to help prevent cervical cancer is to have regular screening tests starting at age 21. There are two screenings that help with early detection – the pap test (or pap smear) looks for precancers, and the HPV test looks for the virus that can cause the type of cell change that can lead to cervical cancer.
You should get your first Pap test at the age of 21. If your test is normal, you can wait three years for your next test. If you're 30 years old or older, you have three options:
- You can continue getting a Pap test only. If your test is normal, you can also wait three years for your next test.
- You can get an HPV test only. If your test result is normal, you can wait five years for your next test.
- You can get both an HPV and Pap test together. If your test results are normal, you can wait five years for your next tests.
Get the Vaccine!
The HPV vaccine protects against the types of HPV that most often cause cervical cancers. The HPV vaccination is recommended for preteens aged 11 to 12 years but can be given starting at age 9. It is also recommended for everyone through the age of 26, if they have not been vaccinated already. The HPV vaccination prevents new HPV infections but does not treat existing infections or diseases. This is why the HPV vaccine works best when given before any exposure to HPV. You should get screened for cervical cancer regularly, even if you received an HPV vaccine.
What else should I know about the screenings?
If you are 21 to 29 years old and your Pap test result is normal, your doctor may tell you that you can wait three years until your next Pap test. If you are 30 to 65 years old, talk to your doctor about which testing option is right for you – a Pap test only, an HPV test only, or an HPV test along with the Pap test. If you are older than 65, your doctor may tell you that you don’t need to be screened anymore if you have had normal screening test results for several years, or if you have had your cervix removed as part of a total hysterectomy for non-cancerous conditions.
Some women believe that they can stop cervical cancer screening once they have stopped having children. False! Cervical cancer was once one of the most common causes of cancer death for American women. Screening tests offer the best chance to have cervical cancer found early when treatment can be most successful. Despite the benefits of cervical cancer screening, not all women get screened. Most cervical cancers are found in women who have never had a Pap test or who have not had one recently.
What do my test results mean?
It can take as long as three weeks to receive your test results. A Pap test result can be normal, unclear, or abnormal. A normal result means that no cell changes were found on your cervix.
It is common for test results to come back unclear. Your doctor may use other words to describe this result, like equivocal, inconclusive, or ASC-US. These all mean the same thing – that your cervical cells look like they could be abnormal. It is not clear if it’s related to HPV, it could be related to life changes like pregnancy, menopause, or an infection. The HPV test can help find out if your cell changes are related to HPV.
An abnormal result means that cell changes were found on your cervix. This does not automatically mean that you have cervical cancer. Abnormal changes on your cervix are likely caused by HPV and can be minor or serious. Most of the time, minor changes go back to normal on their own. But more serious changes can turn into cancer if they are not removed. The more serious changes are often called “precancer” because they are not yet cancer, but they can turn into cancer over time.
An HPV test result can be either positive or negative. A negative HPV test means you do not have an HPV type that is linked to cervical cancer. A positive HPV test means you do have an HPV type that may be linked to cervical cancer. This also does not mean you have cervical cancer now, but your doctor will discuss the risk with you and what your specific options are.
What are the symptoms?
Early on, cervical cancer may not cause noticeable signs and symptoms. Symptoms usually appear once the cancer becomes more invasive and spreads to nearby parts of the body. Once the pre-cancer develops into cancer, the symptoms become noticeable. Some symptoms include abnormal vaginal bleeding, bleeding after vaginal sex and after menopause, bleeding and spotting in-between periods, having unusual discharge from the vagina or pain during sex. If you have any of these signs, see your doctor. They may be caused by something other than cancer, but the only way to know is to see your doctor and get an exam.
How is cervical cancer diagnosed and treated?
If your doctor says that you have cervical cancer, you will be referred to a cancer specialist. Cervical cancer is treated in several ways depending on the kind of cervical cancer and how far it has spread. Treatments can include surgery, chemotherapy, and radiation therapy. Choosing the treatment that is right for you may be hard, which is why we encourage you to speak with our Oncology Nurse Navigator, Karen Houston. Karen can help you and your family through the complex world of cancer screenings, diagnosis, treatment, and follow up care. For more information or to ask a question about our cancer screenings, diagnosis, and treatment services, please call Karen at (518) 213-0308.
Women have unique healthcare needs, which is why it is so important to have regular well-woman visits with your health care practitioner. If your doctor doesn’t perform gynecological exams as part of our yearly physical, Community Care Physicians has several gynecology practices located throughout the Capital Region. For more information on our services, contact our Concierge Care Coordinator at (518) 782-3800.
Sources
https://www.cdc.gov/cancer/dcpc/resources/features/cervicalcancer/index.htm
https://www.cancer.org/latest-news/special-coverage/cervical-health-awareness-month.html
https://www.cdc.gov/cancer/cervical/basic_info/index.htm