Southwest Florida's Health and Wellness Magazine Health and Wellness Articles
By Kathleen M Marc, MD, FACOG
Cervical cancer is a type of cancer that affects the cervix, which is the lower part of the uterus (womb) that opens at the top of the vagina. Cervical cancer is the fourth most common cancer in women worldwide. In the United States approximately 12,000 new cases of cervical cancer will be diagnosed every year and approximately 4,000 women will die from the disease.
Cervical cancer is largely preventable through regular screenings and the HPV vaccine. It is important for women to get regular screenings and to talk to their healthcare providers about the HPV vaccine to help prevent cervical cancer.
Cervical cancer has been found to be caused by the human papillomavirus (HPV), which is a common virus that is transmitted through sexual contact. Between 75 and 80% of sexually active adults will be exposed to HPV in their lifetime. There are many different types of HPV, and some types can cause changes in the cells of the cervix that can lead to cancer. The “high-risk” types can cause cancer of the cervix, anus, vulva, vagina, and penis. They can also cause cancers of the head and neck. Other HPV types have been associated with genital warts.
The HPV vaccine is a vaccine that helps protect against certain types of HPV that are most commonly linked to cervical cancer and other types of cancer. The vaccine is usually given as a series of shots, and it is recommended for girls and boys around the age of 11 or 12, although it can be given to anyone up to the age of 45. It is very important for boys to also get the vaccine to help protect themselves against cancer of the penis, head, and neck. There is currently no test for men, so men can also unknowingly pass HPV on to their partners.
The HPV vaccine works by helping the body build immunity to the virus, which can help prevent infection with the types of HPV that are most often linked to cervical cancer. It is important to note that the HPV vaccine does not protect against all types of HPV, so it is still important for women to get regular screenings even if they have received the vaccine.
In addition to the HPV vaccine, regular screenings such as Pap tests and HPV tests can help detect early signs of cervical cancer and other changes in the cervix, which can be treated before they turn into cancer. Regular screenings and the HPV vaccine are important tools for preventing cervical cancer.
The screening recommendations for women to detect cervical cancer and other changes in the cervix vary depending on a woman’s age, medical history, and other factors. Here are some general guidelines for cervical cancer screening:
• Women between the ages of 21 and 29 should have a Pap test every 3 years.
• Women between the ages of 30 and 65 should have a Pap test alone every 3 years, a Pap Smear and an HPV test every 5 years, or just an HPV test every 5 years.
• Women over the age of 65 who have had regular screenings with normal results and no history of cervical cancer or serious precancerous lesions do not need further
screening.
• Hysterectomy with removal of the cervix – no screening in individuals who do not have a history of high grade cervical precancerous lesions, cervical cancer or DES exposure
These guidelines do not apply to women at high risk of the disease. It is important to note that these are general guidelines and that the specific screening recommendations for an individual woman may vary based on her medical history and other factors. It is very important to talk to your healthcare provider about your specific screening needs and risk factors and to follow their recommendations.
Some women think that if they don’t need a Pap Smear that they don’t need to see the gynecologist or have a pelvic exam. There are many other conditions that can be found during an exam as well as other symptoms that can be a clue to different conditions. It is important that women discuss how frequently their exam should be performed with their doctor.
What can be done to fight off the virus if diagnosed with it? There are studies which show that a supplement called “Indole-3-Carbinol” can help clear the virus. This contains substances found in cruciferous vegetables such as broccoli, cauliflower and Brussel sprouts. Eating these vegetables is also helpful.
Cervical cancer screening continues to evolve. Future recommendations may be based on HPV screening alone. Current recommendations call for stopping Pap Smears in women over 65 who are are at low risk and have had 3 negative Pap Smears or two negative Pap Smears with HPV testing or HPV testing alone in the previous ten years. There is some anecdotal evidence that Gyn Oncology doctors are starting to see an increase in cervical cancer in the older population since these new guidelines took effect. This could be due to women losing a spouse or getting divorced and possibly having a new partner with new HPV exposure. It’s important for women to continue to evaluate changing risks over time with their doctor and decide on the best screening for them.
Kathleen M Marc, MD, FACOG
Clinical Instructor Harvard Medical School
Associate Professor Tufts University School of Medicine
Providing comprehensive gynecological care for women from adolescence to menopause.
Naples Womens Center
239-513-1992
NaplesWomensCenter.com
