Cervical Cancer Awareness: Routine Exams, Regular Screening Key for Prevention

A physician's order for a Pap smear
While once the most common cause of cancer death for women, cervical cancer death rates have decreased significantly with greater use of the Pap test, which can find changes in the cervix before cancer develops or detect it early when it is easier to treat.

January is Cervical Cancer Awareness Month, a good time to shine a light on the disease and the importance of regular screening in its prevention.

The American Cancer Society (ACS) estimates about 13,960 new cases of invasive cervical cancer will be diagnosed in 2023 and 4,310 women will die from the disease.

While once the most common cause of cancer death for women, cervical cancer death rates have decreased significantly with greater use of the Pap test, which can find changes in the cervix before cancer develops or detect it early when it is easier to treat.

The vast majority (98%) of cervical cancers are caused by human papillomavirus (HPV). There are more than 100 types of HPV, but the HPV co-test (done along with the Pap test) screens for the highest risk strains of the virus that are likely to cause cervical dysplasia and cervical cancer.

Along with HPV vaccination, regular screening is the most effective way to prevent cervical cancer. 

According to the American College of Obstetricians and Gynecologists (ACOG), during the past 30 years, the number of cervical cancer cases and deaths in the U.S. has decreased by one-half, because more women are having regular screenings.

ACS statistics show that most cervical cancers diagnosed are found in women who have never had a Pap test or who have not had one recently.

Currently, we don’t have screening tests for all cancers. But cervical cancer is one for which we have an opportunity to meaningfully intervene with regular screening. That’s why it’s so important to get an exam.

In an effort to spread awareness about cervical cancer, here are five things to know about screening, prevention and treatment.

What steps can people take to prevent or reduce the risk of cervical cancer?

HPV vaccination prior to onset of sexual activity can help protect against HPV infection and the development of HPV associated diseases and cancers.

The CDC recommends routine HPV vaccination for girls and boys at age 11 or 12.  The vaccines are approved for people ages 9 through 46, but vaccination in children is most effective in preventing cancer-causing HPV infections. HPV can cause cervical cancer, but also can play a role in vaginal, vulvar, anal, penile, and oro-pharyngeal cancers.

Regular screening is very important for preventing cervical cancer.  The American College of Obstetricians and Gynecologists (ACOG) recommends that cervical cancer screening should begin at age 21 for most patients. 

Guidelines should be followed based on age, risk factors, HPV status, and Pap smear cytology to determine the frequency of routine screening.

A gynecologist speaks with a young female patient
Regular screening with the Pap test, HPV test, or a co-test including both, is very effective in the prevention of cervical cancer.

What kind of screening is available for cervical cancer and at what age should people start?

Cervical cancer screening currently includes Pap smears with cytology (evaluation of cells), primary HPV testing, or co-testing that involves both tests on one swab.

The Pap smear is a procedure used to collect cells from the cervix to be examined in a lab to find cancer and pre-cancer.

The HPV test looks for infection by high-risk types of HPV that are more likely to cause pre-cancers and cancers of the cervix.

Current guidelines recommend patients should begin cervical cancer screening at age 21.

What are some of the risk factors for cervical cancer and are there lifestyle changes that can lower someone’s risk?

Patients with HPV or persistent HPV infection are at a higher risk of cervical cancer. In fact, the vast majority of cervical cancers are caused by HPV infection.

Immunosuppression, tobacco use, multiple sexual partners, and a high-risk sexual partner can also increase a patient’s risk of having HPV or persistent HPV infection.

HPV vaccination and smoking cessation can help decrease the risk of developing cervical cancer.

What are some symptoms of cervical cancer that someone should be concerned about and discuss with their primary care provider or gynecologist?

Cervical cancer can be present without any symptoms, which is why screening tests are important.

Depending on the size of the cervical cancer, patients may present with abnormal vaginal bleeding, bleeding with intercourse, or abnormal discharge.

What kind of treatment options are available for someone diagnosed with cervical cancer?

If a patient is diagnosed with cervical cancer, the treatment options will depend on the stage of the cancer (how far the cancer has spread).

Treatment options for cervical cancer could include surgery, chemotherapy, immunotherapy, radiation therapy or a combination of these therapies.

 

Katelyn McGovern Dorney, MD is a gynecologic oncologist at the Dana-Farber Brigham Cancer Center in clinical affiliation with South Shore Health. Learn more about Gynecologic Oncology Care at the Cancer Center.