January is Cervical Cancer Awareness Month. Here we share updated screening recommendations to keep you safe.
- Regular screenings can detect cervical cancer and precancerous lesions.
- The HPV vaccine can significantly reduce your risk of developing cervical cancer.
- Dr. Chirag Shah shares insight on the screening process.
[4 MIN READ]
For many years, women dutifully saw their gynecologist for an annual pap test. And that was a good thing. The pap smear is credited with greatly reducing the rates of cervical cancer in the United States; a cancer that was once the leading cause of death among women just 40 years ago, according to the Centers for Disease Control and Prevention (CDC).
Perhaps, that’s why, in the past few years as screening guidelines for cervical cancer have changed, many women are left a little confused and unsure about when to have a cervical cancer screening – and what type is best.
We continue to learn more about cervical cancer and HPV, which is the leading cause of cervical cancer. That understanding leads to better recommendations for women.
“We continue to learn more about cervical cancer and the human papillomavirus [HPV], which is the leading cause of cervical cancer,” explains Chirag A. Shah, M.D., MPH, medical director of Swedish Gynecologic Oncology and Pelvic Surgery. “That understanding leads to better recommendations for women.”
Dr. Shah shares his insight on cervical cancer screenings, yearly visits and the latest updates from the American Cancer Society (ACS).
Understanding the new cervical cancer screening recommendations
The ACS released new screening guidelines for cervical cancer this past fall (2020). Now, recommendations include:
- Women should begin screening at age 25 (instead of age 21).
- An HPV test is the recommended screening (either a pap or HPV test were previously recommended).
- Women only need screening every 5 years (instead of every 3 to 5 years).
- Women older than 65 years of age do not need a cervical cancer screening if prior tests were normal. (No change from previous recommendations.)
See how the ACS recommendations compare to past cervical cancer screening guidelines.
Researchers recommend these changes for a few key reasons:
- HPV infections often clear up on their own among women. Abnormal results from a pap or HPV test could lead to unnecessary medical interventions in women most likely to clear the virus on their own.
- Cervical cancer is typically a slow-growing cancer. Researchers believe waiting 5 years is sufficient to catch abnormal cell growth, even in its earlier stages.
- An HPV test is considered more reliable and accurate than a pap test. (However, a pap test may still provide important health details to a provider.)
Dr. Shah shares his thoughts on the new recommendations: “It’s important to make sure we are targeting the women most likely to move from HPV to dysplasia to cervical cancer. Waiting until you’re 25 to be screened instead of 21 may help you avoid unnecessary medical procedures that can result from an abnormal test,” he says.
“However, it is important to talk to your provider about what’s best for you. A yearly pap smear can still tell us more about the cytology of the cervix and may even be able to detect other cancers, like endometrial cancer. And, not all cervical cancer is slow-growing. It’s just another reason to never ignore symptoms, questions or concerns you have about your health,” Dr. Shah adds.
Your primary care provider or gynecologist can discuss your risk factors for cervical cancer and identify the schedule and screening test that’s right for you.
Seeing your doctor every year for preventive health care, whether it’s time for a cervical cancer screening or an annual pelvic exam is still recommended even though the screening schedules have changed.
“Women were uncomfortable dropping their annual pap test and getting a cervical cancer screening every three to five years when the new guidelines were first introduced,” Dr. Shah says. “Seeing your doctor every year for preventive health care, whether it’s time for a cervical cancer screening or an annual pelvic exam is still recommended even though the screening schedules have changed. Yearly visits and staying up to date can help keep you healthy and well.”
HPV vaccine key to reducing your risk of cervical cancer
Cervical cancer occurs when cells grow out of control on the cervix. Like any cancer, it can spread – most often to nearby reproductive organs, which can affect a woman’s fertility.
The most common cause of cervical cancer is HPV. While screening tests can identify cancerous and even precancerous growths of the cervix (when they’re easiest to treat), there is another line of defense for women: The HPV vaccine.
The vaccine, first approved by the U.S. Food and Drug Administration (FDA) in 2006, has been proven effective at reducing the rates of cervical precancers. A recent study found that the percentage of precancers caused by certain HPV types decreased by 21.9% in women who received the HPV vaccine, compared to 8.6% from those that were not vaccinated.
And it’s not just cervical cancer the HPV vaccine protects against. HPV can lead to other types of cancers, including vulva, vagina, penis, anus, mouth and throat.
“The HPV vaccine is really a modern medical breakthrough,” explains Dr. Shah. “We could have a much bigger impact on HPV if there was a broader acceptance of the vaccine.”
Vaccinating young adults may be particularly important as researchers and providers are finding that some newer variants of HPV infections – and subsequent cervical cancers – are more aggressive.
Some parents may be hesitant to vaccinate their child for a virus that is sexually transmitted; while others may not be aware it’s available for boys and girls, beginning at age 11 and 12.
- Two doses of the vaccine for children between ages 11 and 12.
- The vaccine can be given to children as young as 9 years old.
- Individuals who receive their first HPV vaccine after age 15 need three doses.
- Some adults ages 27 through 45 years can talk to their doctor about getting the HPV vaccine if they didn’t receive it in their youth.
Vaccinating young adults may be particularly important as researchers and providers are finding that some newer variants of HPV infections – and subsequent cervical cancers – are more aggressive.
“Virus mutations are on everyone’s minds right now during the COVID-19 era, but viruses have always mutated,” Dr. Shah says. “We may be seeing that now with HPV and the types of cervical cancer it causes, which is really another reason for regular screenings and vaccination.”
Diagnosing and treating cervical cancer will continue to improve as scientists, researchers and medical experts learn more about the disease. As that happens, you can rely on your primary care provider and gynecologist to share the latest information, including how it impacts your health.
--
Find a doctor
Swedish Cancer Institute - Gynecologic Oncology and Pelvic Surgery specializes in gynecologic cancers and complex gynecology. The practice features six gynecologic oncologists who have been serving the Pacific Northwest for more than 30 years and are leaders in ovarian cancer research. In addition, they have expertise in minimally-invasive surgery and have successfully completed more than 7,000 robotic surgeries.
Swedish Gynecologic Oncology and Pelvic Surgery is located at 1101 Madison Street, Suite 1500 in the First Hill Madison Tower, Seattle, WA. Satellite clinics are conveniently located in the Puget Sound area in Issaquah, Bellevue, Renton and Everett.
For more information, or to schedule an appointment, call: 206-991-2000.
Whether you require an in-person visit or want to consult with a doctor virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow-up as needed. If you need to find a doctor, you can use our provider directory.
Find out more about how we’re handling COVID-19.
Related resources
CDC recommendations: HPV vaccine
CDC: Cervical cancer data and statistics
ACS’s Updated Cervical Cancer Screening Guidelines Explained
This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
About the Author
More Content by Swedish Wellness & Lifestyle Team
