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Friday, January 27, 2012

Cervical Cancer Risk and Prevention

January is cervical cancer awareness month. This article is part two in a series that discusses cervical cancer, its prevention, symptoms and treatment.

Cervical Cancer Risk and Prevention

Most risk factors for cervical cancer, like age and family history, cannot be prevented. Patients who feel they are at higher risk for cervical cancer may benefit from consulting with a risk assessment specialist through one of Penn Medicine’s programs at the Abramson Cancer Center or the Joan Karnell Cancer Center at Pennsylvania Hospital.

Cervical Cancer Risk Factors

Risk factors affect the chance of developing cervical cancer. Having a risk factor, or even several, does not mean that someone will get cancer.
All women need to be aware of the risk factors for cervical cancer, and what they can do to prevent it.

Penn Medicine gynecologists work with patients to identify their risk of developing cervical cancer and the steps they can take to lower their risk.
The human papilloma virus, or HPV, causes the majority of cervical cancers. HPV is a group of more than 100 related viruses that can infect cells on the surface of the skin, genitals, anus, mouth and throat.

Genital HPV is the most common sexually transmitted virus in the United States. An estimated 75 to 80 percent of males and females will be infected with HPV during their lifetime. For most people, the virus clears on its own. When it doesn’t, HPV can cause genital warts, precancerous dysplasia and cervical, vulvar or vaginal

Other risk factors for cervical cancer include:
  • Having sex early
  • Multiple sexual partners, or having sex with someone who has had multiple partners
  • Sexual partners who have multiple partners or who participate in high-risk sexual activities
  • A weakened immune system
  • Lack of regular pap tests
  • Weakened immune system
  • Smoking
  • Long term birth control use
  • Having more than 5 children
  • DES exposure
  • Poor economic status or inadequate health coverage
  • HPV infection or genital warts
Cervical cancer is easily treated if it is caught early, so it is important for women to get regular screening exams including a Pap test and HPV test.

Cervical Cancer Prevention


Penn Medicine gynecologists recommend several methods to prevent cervical cancer. Regular screenings, vaccines for preventing the human papilloma virus (HPV) and lifestyle choices can prevent cervical cancer or help find cervical cancer at an early stage when it is most treatable.

Pelvic Exam, Pap Test and HPV Test

Pelvic exams, Pap test screening and HPV testing can detect cervical cancer in its early stages. Pap tests are one of the most effective screening tools used to determine if women have infections, abnormal (unhealthy) cervical cells, cervical cancer or other reproductive problems. A Pap test is the screening of cells scraped from the cervix during a pelvic exam that are examined under a microscope. Pap tests screen for pre-cancers and cancer, but do not provide a final diagnosis.

The American College of Obstetrics and Gynecologists (ACOG) recommends that cervical cancer screening begin at age 21. Most women under the age 30 should undergo cervical screening once every two years and women 30 and older with no other risk factors can be screened every three years. These are not the guidelines. See below.

  • Under 21 and never sexually active: No pap
  • Adolescent: Within 3 yrs of onset of sexual activity
  • 21 to 29 years old: Annual pelvic exam with Pap Smear
  • 30 to 64 years old: ACOG recommends annual Pap. After 3 consecutive normal paps, screening = every 2-3 years. (This is only if the patient has never had CIN 2 or 3, is not immune-compromised or HIV-positive, and has not been exposed to diethylstilbestrol (DES) in utero.
  • 65 and older:  Pap Smears may be disontinued if the woman has had 3 or more consecutive negative paps; no abnormal tests in the previous 10 years; no history of cervical cancer; no DES-exposure; is HIV negative and has a normal immune system; and has no other risk factors for STDs. 
The above was taken from http://www.kltv.com/story/10543955/acog-changes-pap-smear-guidelines. i had trouble accessing the ACOG site.

Preventing HPV: The HPV vaccine

Vaccines are now available that protect against four major types of HPV, including the two types that cause about 70 percent of cervical cancer cases and two types that cause about 90 percent of genital warts.

The HPV vaccine is expected to be long-lasting, but because the vaccine does not protect against all HPV types that cause cervical cancer vaccinated women still need cervical cancer screening (Pap tests and HPV tests). The vaccine does prevent HPV, but does not protect against HPV exposure before vaccination. Also add that it is not a cure.

Condoms do not protect completely against HPV because they don't cover all of the potential HPV-infected areas of the body. However, condoms do provide some protection against HPV, and they protect against HIV and other sexually transmitted diseases.

Although penetrative intercourse is not necessary to get and spread HPV women can do the following to decrease their risk of cervical cancer:
  • Stay up-to-date with recommended paps and exams.
  • Avoid smoking
  • Avoid early onset of sexual activity and sexual activity with people who have had several sexual partners.
  • Use condoms
  • Try to maintain a healthy immune system
  • Limit the amount of sexual partners

Women may avoid HPV, and therefore reduce their risk of cervical cancer, by waiting to have sex until they are older and limiting the number of sexual partners. They should also avoid having sex with anyone who has had multiple sexual partners.

Learn more about cervical cancer treatment at the Abramson Cancer Center.

Learn more about the Jordan Center for Gynecologic Cancer.

Learn more about the MacDonald Women’s Cancer Risk Evaluation Center.

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