Cervical cancer is one of the few cancers that’s almost totally preventable. The rate of death from this disease has dropped by more than half in the past few decades.
Why? It comes down to being able to avoid human papillomavirus, or HPV, which is sexually transmitted. HPV is the top cause of cervical cancer, though it doesn’t always cause the disease. Many people have HPV and don’t develop cervical cancer. But a vaccine targets some of the riskiest strains of HPV. And gynecologists routinely perform Pap smears, which can detect almost all cervical cancers. They may also screen for HPV.
You can also make some lifestyle choices that will lower your chances of getting HPV so that you’re less likely to get cervical cancer.
Cervical Cancer Facts
There are two types of cells in the cervix, the lower part of the uterus that connects it to the vagina: squamous cells and glandular cells. Between 80% and 90% of cervical cancer cases start in the squamous cells (squamous cell carcinoma). The rest start from glandular cells and are called adenocarcinoma.
Early-stage cervical cancer rarely has symptoms. You might not know anything is wrong until the cancer is more advanced. Then you could have irregular vaginal bleeding or discharge, or pain during sex. Fortunately, screening tests can detect cervical cancer, and the HPV virus that usually causes it, very early.
Also, cervical cancer is slow-growing. It usually takes a few years for a normal cervical cell to turn into a cancerous one, if it ever does. Finding and treating pre-cancerous cells is the best way to prevent cervical cancer.
The Pap Test
A Pap test is your first line of defense against cervical cancer. During a pelvic exam, your gynecologist will take a sample of your cervical cells to look for ones that could become cancer. Those precancerous cells might never become a problem. But it’s best to find out and get rid of them to be safe.
If you have an abnormal Pap test, your doctor will do more tests to look more closely at the cervix and remove more tissue from your cervix for a biopsy. Identifying precancerous cells will allow treatment to prevent them from becoming cancer.
There are a number of ways your doctor can get rid of the precancerous cells. Usually, they can physically remove the tissue with a cone biopsy or destroy it with laser treatment or cryosurgery (freezing). These treatments almost always work.
If your Pap test shows cancerous cells, your doctor will do more tests to figure out what stage the cancer is in. Surgery, radiation, and chemotherapy are all treatment options, and the success rate will depend on how early the cancer was caught.
It’s important to get a Pap test regularly. Talk to your doctor about how often you should have one. The U.S. Preventive Services Task Force (USPSTF) recommends that starting at age 21, women should get a Pap test every 3 years until age 65.
If you are between 30 and 65 years old, you can add a test for high-risk HPV and extend your screening to every 5 years. Or continue testing every 3 years with just a Pap smear. If you’re older than that, you may be able to stop testing if you have not had any abnormal Pap smears during routine screening.
The HPV test is used in combination with the Pap test as a way of strengthening the ability to detect cervical cancer. Because cervical cancer is so tied to HPV, it has many of the same risk factors. The more sexual partners you’ve had and the earlier you started having sex, the more likely you are to get HPV and cervical cancer. It’s the most common sexually transmitted disease in the United States.
Low-risk HPV types cause genital warts, while high-risk types of HPV, like HPV 16 and 18, cause cervical as well as vulvar, vaginal, penile, and mouth and throat cancers. But having HPV doesn’t mean that you’ll get cervical cancer.
The USPSTF recommends screening using the high-risk HPV (hrHPV) test alone or a combination of the Pap and hrHPV test every 5 years for women over 30. This combination is called cotesting, and it’s the best way to find early cervical cancer.
The HPV Vaccine
There are more than 100 kinds of HPV, but two of them (types 16 and 18) cause more than half of all cervical cancers. The HPV vaccine targets them.
The ideal time to get the HPV vaccine is before you’re sexually active. So they’re available for children starting as young as 9 years old. Experts recommend boys, girls, and women get the HPV vaccine between ages 11 to 26 to protect them from getting HPV.
The vaccine is given in three doses over about 9 months. For children starting any HPV series when they are younger than 15 years old, they need only two doses instead of three. Although the vaccine is more commonly given before age 26, it has been approved for use up to age 45.
Other Risk Factors
When it comes to things that can cause cervical cancer, there are several that you control. Some you cannot, however, like family history. If your mother or sister has had cervical cancer, you’re two to three times more likely to have it than if they didn’t have it.
Age is another issue. Most women who get cervical cancer are between the ages of 20 and 50.
If you’re a smoker, you have double the chance of getting cervical cancer than a nonsmoker. Researchers think that tobacco byproducts can start the cell changes that make cancer develop.
Other things that increase your chances of getting cervical cancer include:
- Long-term use of the birth control pill
- Three or more full-term pregnancies
- Poverty (makes you less likely to be screened regularly)
- Weakened immune system
- A first pregnancy before age 17
What Else You Can Do
If you’re already sexually active and too old for the vaccine, your best method of prevention is to keep up with your doctor appointments.
You’re also less likely to get HPV if you have fewer sex partners. Ideally, they would also not have a lot of partners, so they are less likely to expose you to HPV.
It may also help to: