January is Cervical Cancer Awareness month. Represented by the color teal, the global initiative aims to increase awareness about cervical cancer, HPV, and the importance of early detection. Local organizations and events also raise funds for research into cause, prevention, diagnosis, treatment, and to eventually find a cure.
Years ago, cervical cancer was the number one cause of cancer-related death for women in the United States. Early detection and treatment have improved dramatically over the last 40 years, reducing the mortality rate, yet cervical cancer is the fourth most common cancer in women, claiming the lives of more than 300,000 women globally every year.
Cervical cancer can be prevented through vaccination, as well as regular screenings and treatment.
We at CercaTalent+ are joining in by sharing valuable information around detection and prevention. Do know, this gets a tad clinical, meaning there are some grown up words in the article that follows. Still, as a “girl dad”, I am clear this is critical intel for helping in the work of prevention and eventually finding a cure.
What is cervical cancer?
Cervical cancer is a type of cancer that starts in the cervix. The cervix is a hollow cylinder that connects the lower part of a woman’s uterus to her vagina. Most cervical cancers begin in cells on the surface of the cervix.
Cervical cancer was once a leading cause of death among American women. That has changed since screening tests became widely available.
Cervical cancer statistics
The American Cancer Society estimates that in 2019, approximately 13,170 American women will be diagnosed with cervical cancer and 4,250 will die from the disease. Most cases will be diagnosed in women between the ages of 35 and 44.
Hispanic women are the most likely ethnic group to get cervical cancer in the United States. Native Americans and Alaskan natives have the lowest rates.
The death rate from cervical cancer has dropped over the years. From 2002-2016, the number of deaths was 2.3 per 100,000 women per year. In part, this decline was due to improved screening.
Symptoms of cervical cancer
Many women with cervical cancer don’t realize they have the disease early on, because it usually doesn’t cause symptoms until the late stages. When symptoms do appear, they’re easily mistaken for common conditions like menstrual periods and urinary tract infections (UTIs).
Typical cervical cancer symptoms are:
- unusual bleeding, such as in between periods, after sex, or after menopause
- vaginal discharge that looks or smells different than usual
- pain in the pelvis
- needing to urinate more often
- pain during urination
If you notice any of these symptoms, see your doctor for an exam. Find out how your doctor will diagnose cervical cancer.
Cervical cancer causes
Cancer is the result of the uncontrolled division and growth of abnormal cells. Most of the cells in our body have a set lifespan, and, when they die, the body generates new cells to replace them.
Abnormal cells can have two problems:
- they do not die
- they continue dividing
This results in an excessive buildup of cells, which eventually forms a lump, or tumor. Scientists are not completely sure why cells become cancerous.
Most cervical cancer cases are caused by the sexually transmitted human papillomavirus (HPV). This is the same virus that causes genital warts.
There are about 100 different strains of HPV. Only certain types cause cervical cancer. The two types that most commonly cause cancer are HPV-16 and HPV-18.
Being infected with a cancer-causing strain of HPV doesn’t mean you’ll get cervical cancer. Your immune system eliminates the vast majority of HPV infections, often within two years.
HPV can also cause other cancers in women and men. These include:
HPV is a very common infection. Find out what percentage of sexually active adults will get it at some point in their lifetime.
Cervical cancer treatment
Cervical cancer is very treatable if you catch it early. The four main treatments are:
Sometimes these treatments are combined to make them more effective.
The purpose of surgery is to remove as much of the cancer as possible. Sometimes the doctor can remove just the area of the cervix that contains cancer cells. For cancer that’s more widespread, surgery may involve removing the cervix and other organs in the pelvis.
Radiation kills cancer cells using high-energy X-ray beams. It can be delivered through a machine outside the body. It can also be delivered from inside the body using a metal tube placed in the uterus or vagina.
Chemotherapy uses drugs to kill cancer cells throughout the body. Doctors give this treatment in cycles. You’ll get chemo for a period of time. You’ll then stop the treatment to give your body time to recover.
Bevacizumab (Avastin) is a newer drug that works in a different way from chemotherapy and radiation. It blocks the growth of new blood vessels that help the cancer grow and survive. This drug is often given together with chemotherapy.
If your doctor discovers precancerous cells in your cervix they can be treated. See what methods stop these cells from turning into cancer.
Cervical cancer stages
After you’ve been diagnosed, your doctor will assign your cancer a stage. The stage tells whether the cancer has spread, and if so, how far it’s spread. Staging your cancer can help your doctor find the right treatment for you.
Cervical cancer has four stages:
- Stage 1: The cancer is small. It may have spread to the lymph nodes. It hasn’t spread to other parts of your body.
- Stage 2: The cancer is larger. It may have spread outside of the uterus and cervix or to the lymph nodes. It still hasn’t reached other parts of your body.
- Stage 3: The cancer has spread to the lower part of the vagina or to the pelvis. It may be blocking the ureters, the tubes that carry urine from the kidneys to the bladder. It hasn’t spread to other parts of your body.
- Stage 4: The cancer may have spread outside of the pelvis to organs like your lungs, bones, or liver.
Cervical cancer testing
A Pap smear is a test doctors use to diagnose cervical cancer. To perform this test, your doctor collects a sample of cells from the surface of your cervix. These cells are then sent to a lab to be tested for precancerous or cancerous changes.
If these changes are found, your doctor may suggest a colposcopy, a procedure for examining your cervix. During this test, your doctor might take a biopsy, which is a sample of cervical cells.
The U.S. Preventive Services Task Force (USPSTF)Trusted Source recommends the following screening schedule for women by age:
- Ages 21 to 29: Get a Pap smear once every three years.
- Ages 30 to 65: Get a Pap smear once every three years, get a high-risk HPV (hrHPV) test every five years, or get a Pap smear plus hrHPV test every five years.
Do you need a Pap smear? Learn what to expect during a Pap test.
Cervical cancer risk factors
HPV is the biggest risk for cervical cancer. Other factors that can also increase your risk include:
- human immunodeficiency virus (HIV)
- a family history of cervical cancer
- a diet low in fruits and vegetables
- taking birth control pills
- having three full-term pregnancies
- being younger than 17 when you got pregnant for the first time
Even if you have one or more of these factors, you’re not destined to get cervical cancer. Learn what you can start doing right now to reduce your risk.
Cervical cancer prognosis
For cervical cancer that’s caught in the early stages, when it’s still confined to the cervix, the five-year survival rate is 92 percent.
Routine testing is important for improving the outlook of women with cervical cancer. When this cancer is caught early, it’s very treatable.
Cervical cancer surgery
Several different types of surgery treat cervical cancer. Which one your doctor recommends depends on how far the cancer has spread.
- Cryosurgery freezes cancer cells with a probe placed in the cervix.
- Laser surgery burns off abnormal cells with a laser beam.
- Conization removes a cone-shaped section of the cervix using a surgical knife, laser, or a thin wire heated by electricity.
- Hysterectomy removes the entire uterus and cervix. When the top of the vagina is also removed, it’s called a radical hysterectomy.
- Trachelectomy removes the cervix and the top of the vagina but leaves the uterus in place so that a woman can have children in the future.
- Pelvic exenteration may remove the uterus, vagina, bladder, rectum, lymph nodes, and part of the colon, depending on where the cancer has spread.
Cervical cancer prevention
Early detection is key for prevention and treatment of cervical cancer. Cervical cancer is one of the easiest gynecological cancers to prevent with regular screening tests, There are two screening tests proven effective to detect cervical cancer early.
Cervical cancer is preventable – a Pap smear can find precancerous changes in the cervix and an HPV test can determine if you carry the virus. With this test, cells are collected and sent to a laboratory to look for any abnormalities. Young women should begin screening with this test at the age of 21 or when they become sexually active. Follow-up screenings then occur every three years, regardless of the age of onset in sexual activity.
The second test screens for Human Papilloma Virus, or HPV. The human papilloma virus is the leading cause of cervical cancer. The Pap and HPV tests can be combined for early detection. If both of these tests are normal, no further testing is necessary again for another five years.
The HPV screening exam is recommended to start around the age of 30. Women should work with a gynecologist or primary care provider to find out the recommended frequency of screenings after age 30. There are many guidelines out there, and it can be confusing for patients because they change frequently. Physicians will look at a patients’ medical history and make a decision with them about how often they should be screened. The important takeaway is that women remember to get the screening done!
In 2018, the the U.S. Preventive Services Task Force (USPSTF) updated its cervical cancer screening guidelines. Women over the age of 30 now have the option of choosing an HPV test only, which has been shown to be effective in screening for cervical cancer. They also still have the option of the traditional Pap smear as well as the Pap smear and HPV test combination.
If caught early, cervical cancer has a high survival rate. Abnormal cells seen on Pap tests are precancerous [rather than cancerous] the vast majority of the time. An abnormal Pap smear result indicates you have precancerous cells in your cervix. Find out what to do if your test comes back positive.
Here are a few other ways you can reduce your risk of HPV and cervical cancer:
- limit the number of sexual partners you have
- always use a condom or other barrier method when you have vaginal, oral, or anal sex
Cervical cancer and pregnancy
It’s rare to get diagnosed with cervical cancer while you’re pregnant, but it can happen. Most cancers found during pregnancy are discovered at an early stage.
Treating cancer while you’re pregnant can be complicated. Your doctor can help you decide on a treatment based on the stage of your cancer and how far along you’re in your pregnancy.
If the cancer is at a very early stage, you may be able to wait to deliver before starting treatment. For a case of more advanced cancer where treatment requires a hysterectomy or radiation, you’ll need to decide whether to continue the pregnancy.
Doctors will try to deliver your baby as soon as it can survive outside the womb.
Here are 10 more important facts about the HPV detection and its relation to cervical cancer:
HPV IS COMMON
Most sexually active individuals have HPV at some point. At any time, there are approximately 79 million people in the U.S. with HPV.
Some types of HPV can cause genital warts while some other, different types are linked to cervical cell changes that, if not detected early, can increase a womanʼs risk for cervical cancer. HPV also causes some cancers of the penis, anus, vagina, vulva, and throat. HPV infections are usually harmless, though, and most are cleared naturally by the body in a year or two.
HPV vaccines can help prevent infection from both high-risk HPV types that can lead to cervical cancer and low risk types that cause genital warts. The CDC recommends all boys and girls get the HPV vaccine at age 11 or 12. The vaccine produces a stronger immune response when taken during the preteen years. For this reason, up until age 14, only two doses are the vaccine are required. Women and men can get the vaccine up to age 45, but for those 15 and older, a full three-dose series is needed.
HPV is usually passed by genital-to-genital and genital-to- anal contact (even without penetration). The virus can also be transmitted by oral to genital contact, although this probably occurs less often. Studies show that male condoms can reduce HPV transmission to females, although condoms only protect the skin they cover.
A Pap test can find cell changes to the cervix caused by HPV. HPV tests find the virus and help healthcare providers know which women are at highest risk for cervical cancer. A Pap/HPV co-test is recommended for women 30 and over. One HPV test has been approved for use as primary cervical cancer screening for women age 25 and older, followed by a Pap test for women with certain results.
Thereʼs no treatment for the virus itself, but healthcare providers have plenty of options to treat diseases caused by HPV.
It can take weeks, months, or even years after exposure to HPV before symptoms develop or the virus is detected. This is why it is usually impossible to determine when or from whom HPV may have been contracted. A recent diagnosis of HPV does not necessarily mean anyone has been unfaithful, even in a long-term relationship spanning years.
Pregnant women with HPV almost always have natural deliveries and healthy babies — itʼs very rare for a newborn to get HPV from the mother.
THE EMOTIONAL SIDE
It can be upsetting when HPV is first diagnosed, but remember that having HPV is normal! It doesnʼt mean that anyone did something wrong, just that like most others they were exposed to a common infection. There are 14 million new HPV infections in the U.S. each year alone!
The American Sexual Health Association and the National Cervical Cancer Coalition have online support communities at Inspire.com that connect patients, partners, and caregivers. These are safe places where thousands of users find the information and support they need.
Here are 10 important facts about the prevention, detection and treatment of cervical cancer:
- Approximately 13,000 women are diagnosed with cervical cancer each year.
- Most cases are caused by certain strains of human papillomavirus (HPV), a sexually transmitted virus.
- Cervical cancer typically has no symptoms in early stages.
- It is often detected early thanks to routine annual pelvic exams and Pap tests, so schedule a yearly exam with your gynecologist.
- When found in the precancerous stage, cervical cancer is 100 percent curable with proper treatment and follow up.
- It occurs most often in women who are over the age of 30.
- Risk factors include: HPV, HIV, age, smoking, having sexual intercourse before age 18 and having many sexual partners.
- Symptoms in later stages include abnormal bleeding or discharge, as well as pain during intercourse.
- Because strains of HPV can cause cervical cancer, HPV vaccines were developed to protect females against strains that lead to vulvar, vaginal and cervical cancer.
- Treatment for cervical cancer includes surgery, radiation therapy, chemotherapy, biological therapy or interferon.
Protect Our Children – Available Vaccines
HPV is one of the most common sexually transmitted diseases and causes almost all incidents of cervical cancer. When a female is infected with HPV, and the virus does not go away on its own, abnormal cells develop in the lining of her cervix. If these cells are not caught early by a Pap test or HPV screening, and then subsequently treated, pre-cancer and cancerous cells can develop.
There are currently two vaccines available to help prevent certain types of cervical cancer: Gardasil and Cervarix. The FDA (Food Drug Administration) has approved Gardasil for use in females and males from ages nine to 26. The vaccine prevents four types of HPV that can lead to the development of cervical and other varieties of cancer.
Cervarix is also FDA-approved for prevention of cervical cancer caused by two distinct types of HPV. The CDC (Center for Disease Control) recommends that all kids, starting at 11- or 12-years-old, should get the three-dose series of the Cervarix vaccine to protect against HPV. For teen boys and girls who did not start or finish the HPV vaccine series when they were younger, they should get it now. Young women can get the HPV-vaccine series through the age of 26, and young men can get vaccinated through age 21.
The subject of disease prevention, and especially of sexually transmitted diseases, is a sensitive issue. Parents should talk to their medical providers about the vaccines and decide which one will be the best fit for their child. These vaccines are proving effective against preventing cervical cancer in adulthood.
The Centers for Disease Control and Prevention (CDC) initially recommended the vaccine for all people aged 9–26 years. However, the CDC now advise that the vaccine is also available for all women and men aged 26–45 years who did receive the vaccine as a preteen.
As someone interested in educating and advocating for increased knowledge of cervical cancer and HPV disease, you can do a lot. You can contact your local media to encourage coverage of Cervical Health Awareness Month, offering this ASHA/NCCC press release. You can also send this proclamation to your mayor, or local legislative office to publicly recognize Cervical Health Awareness Month.
You might check out the resources below where you will find fact sheets to episodes of ASHA’s Sex+Health podcast, to educate yourself and others. Download, display and distribute the National Cervical Cancer Coalition’s awareness month posters and help NCCC and ASHA get the word out on social media.
Get involved in the Cervical Cancer Awareness campaign by wearing the teal ribbon, distributing handouts and flyers within your community, attending fundraiser events, and visiting your medical provider for screening tests and vaccinations.
Healthline.com, Everything You Need to Know About Cervical Cancer, Last medically reviewed on September 3, 2019
10 Things You Need to Know About Cervical Cancer, Piedmont.Org
Centers for Disease Control and Prevention, Cervical Cancer
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