The Crux of Cervical Cancer Screening and Vaccination

by Dr. Rotem Amir

With the recent media overload regarding cervical cancer awareness and the newly available vaccine, I find it necessary to give my female patients more information about the second most common cancer in women. Since most cervical cancers take several years to develop, you and your physician can aggressively screen and help prevent this serious health concern.

Cervical cancer is a cancer of the lower end of the uterus that connects to the vagina. Cervical cancer occurs when normal cells in the cervix change into cancer cells. The good news is that there are ways to help prevent cervical cancer. By getting regular Pap tests and pelvic exams, your health care provider can find and treat the changing cells before they turn into cancer. For some patients, a new vaccine is now FDA approved for the prevention of cervical cancer.

Are You at Higher Risk?

Doctors cannot always explain why one woman develops cervical cancer and another does not. We do know that women with certain risk factors may be more likely than others to develop cervical cancer. Studies have found several factors that may increase the risk of cervical cancer.

Human papillomaviruses (HPVs): HPV infection is the main risk factor for cervical cancer. HPV viral infections commonly infect the cervix, for they are easily passed from person to person through sexual contact. Although most adults have been infected with HPV at some time in their lives without any symptoms, some types of HPV can cause changes to cells in the cervix such as genital warts or cancer.
Lack of regular Pap tests
HIV, AIDS, or drugs that suppress the immune system
Older age
Numerous sexual partners or early age of first intercourse
Tobacco abuse
Oral contraceptives
Multiple pregnancies
Diethylstilbestrol (DES) exposure: A fertility drug given to women in 1940-1971

Screen Now

Screening can help the doctor find abnormal cells before cancer develops. For the past several decades, the number of women diagnosed each year with cervical cancer has been falling, largely due to the success of Pap smear screening. During a pelvic exam, your doctor scrapes a sample of cells from the cervix, and then smears the cells on a glass slide. In a new type of Pap test, called liquid-based Pap test, the cells are rinsed into a small container of liquid. The samples are then viewed under a microscope and tested for HPV at the doctor’s request.

HPV Vaccination

Current vaccination recommendations are for women age 9 to 26 years of age, while studies are ongoing to evaluate benefit in older women. In women receiving the vaccine, 98% were protected from developing cervical cancer from HPV. To be fully protected the vaccine is administered as three separate doses over a period of six months. Many insurers are covering some or all of the cost of the vaccine.

In summary, all women should speak with their doctors about when they should begin having Pap tests, how frequent, and women should know their HPV status. For younger women, HPV vaccination is a currently accepted health prevention measure to greatly reduce the risk of developing cervical cancer. Further studies are ongoing to evaluate the benefit in women 26 and older.