According to the American Cancer Society, cervical cancer is preventable and is one of the most successfully treatable cancers if detected soon enough. Getting screened early and often for cervical cancer and its risk factors, such as human papillomavirus (HPV), can increase the possibility of successful prevention and treatment.
Although the overall rate of cervical cancer in the U.S. is in decline, the number of women suffering from advanced stages of the disease is increasing. Black women have an overall higher rate of late-stage cervical cancer, a disease with a five-year survival rate of 17%.
Some experts believe this is due to a decrease in screenings, especially among young women. In an interview with NPR, Dr. Alex Francoeur, a fourth-year OB-GYN resident at UCLA, said she suspects many women put off routine tests because they are otherwise healthy. However, routine screenings could make the difference in a 30-year-old reaching their 35th birthday.
Who is At Risk?
There are several risk factors that increase an individual’s chances of cervical cancer. The most important risk factor for cervical cancer is infection by HPV. The virus is linked to more than 90% of all anal and cervical cancers, as well as a high percentage of other cancers.
HPV can appear and spread in a variety of ways:
- HPV can infect cells on the surface of the skin, and those lining the genitals, anus, mouth and throat, but not the blood or internal organs such as the heart or lungs.
- HPV can spread from one person to another during skin-to-skin contact. One way HPV spreads is through sexual activity, including vaginal, anal, and even oral sex.
- Different types of HPV cause warts on different parts of the body. Some cause common warts on the hands and feet; others tend to cause warts on the lips or tongue.
- Certain types of HPV may cause warts on or around the female and male genital organs and in the anal area. These are called low-risk types of HPV because they are seldom linked to cancer.
Other types of HPV are called high-risk types because they are strongly linked to cancers, including cancer of the cervix, vulva, and vagina in women, penile cancer in men, and cancers of the anus, mouth, and throat in both men and women.
Other risk factors for cervical cancer include:
- Sexual history.
- Having a weakened immune system.
- Chlamydia infection.
- Long-term use of birth control pills.
- Having multiple full-term pregnancies.
- Young age at first full-term pregnancy.
- Economic status.
- Diet low in fruits and vegetables.
- Family history of cervical cancer.
The Centers for Disease Control and Prevention recommends women start getting Pap tests at age 21 and receive a follow-up every three years, depending on their health history. The test screens for precancers, which if detected, can be surgically removed. Cervical cancer detected early enough can have a five-year survival rate of over 90%.
According to the National Cancer Institute guidelines, women should also receive a routine HPV test, separate from a Pap smear. HPV can be cleared by the body naturally in most people. However, it can become chronic if the infection does not go away – this is what can cause certain cancers, including cervical cancer.
HPV is the most common sexually transmitted disease – so common, most sexually active people will contract the virus in their lifetime. There is no cure for HPV infection, but treatments are available for warts and abnormal cell growth. HPV vaccines are also available to help prevent infection by certain types of HPV and some of the cancers linked to those types.
Increasing Cervical Cancer Screenings
Although early and routine cervical cancer screenings have long been proven to reduce new cases and deaths, the percentage of women overdue for these screenings has been growing. According to a study, the most common reason for being overdue for a cervical cancer screening was that the women simply didn’t know they needed one.
Cervical cancer is preventable and treatable with early detection – the incidence of this disease is already higher than it should be and is able to be reduced. Encouraging early and routine cervical cancer screenings, especially among populations most affected, can reduce new cases and treat advanced cases more effectively.
This decline happened as legislation was expanding access to health screenings, as well as expanding Medicaid eligibility and coverage. Although insurance and access to health care certainly pose a barrier for some people, there is a much larger gap needing to be addressed by providers to ensure everyone is equally protected from preventable cervical cancer.
Providers are encouraged to discuss risk factors and recommend screenings to all sexually active patients, especially patients who may lack education and awareness about STDs, HPV, or cervical cancer. It’s important that these discussions are also done in a way that allows patients to feel comfortable discussing sensitive matters, clearly understand what is being explained, and can provide informed consent to any related physical tests or procedures.
The populations most likely to be overdue for screening include Asian and Hispanic women, women in rural areas, women lacking insurance, and women identifying as LGBTQ+. Some important points for providers to consider include taking culturally competent approaches for various ethnic and social backgrounds, providing LGBTQ+-inclusive sexual health education and resources, and addressing sexual health and lifelong consequences to teen patients who may be beginning to experiment with sex.
Preventing Cervical Cancer
Preventing cervical cancer primarily requires a two-pronged approach focused on preventing HPV: getting the HPV vaccine and getting regularly screened for HPV.
Experts stress the importance of the HPV vaccine as a critical tool because it literally prevents cancer, a disease that can drastically alter someone’s life. For teens becoming sexually active for the first time, the HPV vaccine can prevent lifelong and potentially fatal consequences.
The HPV vaccine is available for individuals as young as nine years old and up to age 45, although vaccination is not recommended for everyone older than age 26 years. Learn more about HPV vaccine dosing for every age.
It’s also important to detect HPV as early as possible through regular screenings. The American Cancer Society guidelines recommend that screenings begin at age 25 and continue every five years until age 65. Preferably, patients should receive specifically an HPV test, and should only receive a Pap smear if an HPV test is not available.
Patients should be prepared to ask questions about their personal risk for cervical cancer and HPV and request a screening if one is not provided. The American College of Obstetricians and Gynecologists provides a list of FAQs about cervical cancer and the importance of routine screenings.
In addition, individuals can also lessen their chances of HPV infection by using condoms during sex, and limiting the number of sexual partners. STD testing should occur before sex with a new partner and between sex with different partners.
HPV infection can occur in genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. While the effect of condoms in preventing HPV infection is unknown, condom use has been associated with a lower rate of cervical cancer.
Abstaining from smoking can also reduce one’s risk of HPV infection.
Protect yourself from preventable cancer. Talk to your provider about your cervical cancer risk factors, screening options, and whether you are due for an HPV vaccine.
Learn more about cervical cancer and help raise awareness among partners, family, and friends about the need to get vaccinated and to get screened early and often.