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Cervical cancer screening recommendations have changed over the years, which means you no longer need a yearly Pap test, but you should still schedule a well-woman check.
The HPV vaccine will lower your risk of developing cervical cancer as well as other HPV-related cancers, and the vaccine isn’t just for women and preteens.
Cervical cancer often does not present symptoms in the earliest stages, making it hard to detect — so if you experience any symptoms, don’t hesitate to talk to your provider.
Not only do many health insurance plans reset at the new year, but January is also Cervical Cancer Awareness Month, making it the perfect time to ensure your well-woman visit and screening are on the calendar.
Once one of the deadlier cancers in women, cervical cancer is now considered preventable and treatable. In 2011, an estimated 2.3 women per 100,000 died from cervical cancer, down from 5.6 women per 100,000 in 1975. That’s a decrease of over 50%, primarily due to widespread screening and the development of the HPV vaccine. Today, the American Cancer Society estimates that screening saves more than 4,000 lives a year.
To help you navigate the current recommendations for cervical cancer screenings and human papillomavirus (HPV) vaccination, we spoke with Chirag Shah, M.D., medical director for the gynecological pelvic surgery program at the Swedish Cancer Institute. Here’s his advice for making sure you know how to work with your providers to protect yourself from cervical cancer.
Make cervical cancer screening part of your medical care routine
A cervical screening with a Pap test can detect changes in the cells of the cervix before cancer develops. This makes it possible to find cancer early, which is when it’s easiest to treat.
A cervical exam can include two types of cervical cancer screening tests:
- A Pap test, in which a small sample of cervical cells is sent to the lab to look for changes in cells that could turn into cancer if not treated.
- An HPV test, in which some cells collected during the Pap test are examined for human papillomavirus (HPV), the virus that causes cellular changes to the cervix and may lead to cancer.
These tests can be done simultaneously, and they will not feel any different to you. This is called co-testing; depending on your age and risk factors, your doctor may recommend it.
Dr. Shah recommends that women between the ages of 30 to 65 choose one of these three testing options:
- Have a Pap test and an HPV test (co-testing) every 5 years
- Have a Pap test alone every 3 years
- Have an HPV test alone every 5 years
Doctors used to advise women to get Pap tests every year, but yearly pelvic exams are no longer recommended. You should, however, continue with regular screenings regardless of whether you are sexually active or have received the HPV vaccine.
“Most cervical cancers are relatively slow growing,” says Dr. Shah. “So you do not need to test every year.”
Continue to visit your provider for a well-woman check once a year
Dr. Shah emphasizes that yearly well-woman checks are still recommended, they just do not need to include a Pap test every year.
“The biggest issue in detecting cervical cancer is disparity in care,” he says. “We miss patients who are either resistant to doctor appointments and screenings of any kind, or patients whose socioeconomic status creates barriers in their access to care.”
What is most important in preventing cervical cancer, he adds, is getting patients in for regular checkups and connecting them to care so they can get comfortable with a regular screening schedule.
Get the HPV vaccine to lower your risk
HPV occurs in one in four women, but you don’t have to be a teenager, a young adult or a female to benefit from the HPV vaccine, Dr. Shah says.
“The HPV vaccine lowers your risk of developing cervical cancer, as much as 50%,” he says. “And even if you already have HPV, the vaccine will help your body fight the virus.”
The current HPV vaccine eligibility guidelines include the following:
- All boys and girls starting at age 11 or 12.
- Women up to age 45.
- Men up to age 21.
The Centers for Disease Control and Prevention (CDC) recommends the vaccine regardless of whether someone is sexually active.
HPV usually goes away on its own, and most women with HPV never develop cancer. But when your immune system can’t fight off an HPV infection the HPV can linger. Over time, HPV may turn normal cells into abnormal cells which then develop into cancer if they are not found and removed.
The CDC estimates that about 10% of women with HPV infection on their cervix will develop long-lasting HPV infections that put them at risk for cervical cancer. If you have HPV, your provider may recommend more frequent screenings to make sure the virus does not develop into cancer.
“HPV is a preventable illness, and there is no evidence that the vaccine will lead to risky behaviors,” Dr. Shah adds. “The vaccine has been rigorously tested and it can prevent not just cervical cancers, but other HPV-related cancers including head and neck cancers.”
Know the cervical cancer risk factors
Most cervical cancers are caused by HPV, which can be passed from person to person during sexual intercourse. Often, HPV can be dormant for years without causing any symptoms, but it can develop into cervical cancer.
The most common risk factors for developing cervical cancer include the following:
- Giving birth to three or more children.
- Having multiple sexual partners within a 12-month time period
- HIV (the virus that causes AIDS) or another condition that weakens your immune system.
- Taking birth control pills for five or more years.
Learn to recognize cervical cancer symptoms
Early-stage cervical cancer does not usually have any symptoms, making it difficult to detect without regular screening.
When women do experience early-stage cervical cancer symptoms, they may include:
- Bleeding after sexual intercourse.
- Irregular blood spotting or light bleeding between periods.
- Periods that are heavier or longer than normal.
- Postmenopausal spotting or bleeding.
- Vaginal discharge that may be watery, foul smelling or contain blood.
Advanced cervical cancer that has spread beyond the cervix to other parts of the body may include early-stage cervical cancer symptoms as well as symptoms like:
- Back, leg or pelvic pain.
- Foul-smelling discharge and vaginal discomfort.
- Swelling of a leg or both lower extremities.
- Weight loss, fatigue or loss of appetite.
Feel confident about cervical cancer treatment options
If an abnormality is found as a result of your Pap or HPV test, Dr. Shah says it can sometimes just be followed with another Pap test later on, but for moderate to severe abnormal cells you will need a detailed, visual exam called a colposcopy.
During a colposcopy, a lighted microscope magnifies the tissue lining your cervix and vagina so that if your provider sees any abnormalities, they can biopsy tissue samples to test for cancerous or precancerous cells. The colposcopy procedure can be performed by your primary care provider or a specialist.
“A Pap test is just loose scraping of cells,” says Dr. Shah. “It is not as precise as a biopsy which can get deeper levels of cells to determine the stage of precancer.”
Depending on the result of the colposcopy, the ultimate step is to remove any abnormal cells to prevent them from developing into cancer. This may be done via a:
- Loop electrosurgical incision procedure (LEEP), in which an electricity-powered wire loop destroys the abnormal cells.
- Cone biopsy, in which a cone-shaped sample of tissue that includes the abnormal cells is removed.
- Cryotherapy, which uses cold chemicals, like liquid nitrogen, to destroy abnormal cells.
- Laser surgery
If cervical cancer is found, your treatment options may include:
- Removal of the tumor, but not the cervix.
- A combination of chemotherapy and radiation.
For many women, a hysterectomy is the only procedure necessary, but your treatment will depend on the stage of the cancer.
Learn more and find a provider
To learn more about cervical cancer screening and the HPV vaccine, download our cervical cancer fact sheet and to learn more about cervical cancer treatment, contact the Swedish Cancer Institute. We can accommodate both in-person and virtual appointments.
Join our Patient and Family Advisory Council.
This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.
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