Cervical health screenings help reduce cancer rates
January is Cervical Health Awareness Month
Written By Lauren Glendenning
Brought to you by Kaiser Permanente
Regular gynecological screenings in women have helped reduce the rate of cervical cancer deaths in the United States by more than half in the last 40 years, but risk factors remain for those who aren’t diligent about preventative care.
Cervical cancer affects about 200,000 women in the United States each year, but its main cause — the human papillomavirus (HPV) — is a very common infection.
“The most important risk factor for cervical cancer is infection with HPV,” said Dr. Shannon Garton, Family Medicine Physician with Kaiser Permanente’s Edwards Medical Offices. “Sexual activity with someone who has HPV is the most common way someone gets HPV.”
More than 100 types of HPV exist, but not all are linked to cancer. HPV 16 and 18 are the two types most frequently associated with cervical cancer, Garton said. The majority of the most worrisome types of HPV, including 16 and 18, are preventable thanks to relatively new vaccines available to girls and boys as young as 9 years old, and adults up to the age of 26, according to the Centers for Disease Control and Prevention. Research suggests the vaccine should be given at a young age, before becoming sexually active.
While about 90 percent of HPV infections can clear up on their own over months or years, about 5 percent of HPV infections will result in cervical cancer, said Dr. Patricia Dietzgen, Family Medicine Physician with Kaiser Permanente’s Frisco Medical Offices.
Infection with HPV is the most important risk factor for cervical cancer, Garton said, but women with weakened immune systems or genital herpes have a higher risk of developing cervical cancer.
Like many cancers and serious health conditions, smoking increases the risk of development. Women who smoke are about twice as likely to develop cervical cancer than women who do not smoke, Garton said.
HPV is the most common sexually transmitted infection in the United States, affecting about 79 million Americans, according to the Centers for Disease Control and Prevention.
The American Cancer Society (ACS) reports that cervical cancer tends to occur in midlife, mostly in women younger than 50. Hispanic and African-American women have higher rates of HPV-associated cervical cancer than white and non-Hispanic women, according to the Centers for Disease Control (CDC).
“Girls younger than 15 years old rarely develop cervical cancer. The risk goes up between the late teens and mid-30s,” Garton said. “Women over 40 years old age remain at risk and need to continue having regular cervical cancer screenings, which include both a Pap test and HPV test.”
Pap tests can reveal changes in the cervix before cancer develops, and the tests can also find cancer very early, when it’s most curable, according to the American Cancer Society.
Garton said the HPV virus can lay dormant in the body and may not cause problems until years later. Regular Pap tests can detect abnormal cells that may lead to cancer.
“Cervical cancer can become serious if diagnosed at a late stage or left untreated,” Garton said. “When it is caught early, very minor surgery could take care of the problem. However, later, extensive surgery could be a reality, including a hysterectomy, and treatment with chemotherapy or radiation may be necessary. Regular screening tests can detect pre-cancerous cells and prevent more serious treatments.”
Cervical cancer is the third most common malignancy in women worldwide, but Dietzgen points out that it’s relatively rare in the United States due to routine screening.
In 2013, The American College of Obstetricians and Gynecologists changed screening guidelines for cervical cancer. It now recommends that screening start at age 21, and that women ages 21 to 29 should have a Pap test every three years. Women ages 30 to 65 should have a Pap test and HPV test every five years.
“Of course, these recommendations are general guidelines and if you have an abnormal Pap, the recommendations would be different,” Dietzgen said.