By Jennifer Larson
January is Cervical Cancer Awareness Month, which makes it a great time to learn more about cervical cancer and cervical cancer prevention.
Cervical cancer is cancer of the cervix, the narrow tube at the bottom of the uterus that connects to the vagina. Nearly 13,000 new cases of cervical cancer were diagnosed in the United States in 2016, and 4,188 people died of cervical cancer that same year, according to the Centers for Disease Control and Prevention (CDC).
But those numbers used to be even higher. Cervical cancer was once the leading cause of cancer death for women in the U.S., but prevention efforts are driving the numbers of cervical cancer deaths down.
Two of the main ways to prevent cervical cancer are catching early changes to cells that may herald the development of cervical cancer through screenings and getting vaccinated against human papillomavirus (HPV), which causes many cases of cervical cancer.
Depending on your age and health situation, regular screenings might be an important part of your schedule. Your healthcare provider will look for signs of abnormal tissue or early changes to cells in the cervix, which is known as dysplasia. These can be an early sign of cancer, so the test can identify any problems early on. One note of caution: Not all abnormal cells lead to cancer.
The most common screening tool is the Pap smear, or Pap test. Your doctor or nurse practitioner will insert a small stick or brush into your vagina to gently scrape a few cells from your cervix. It just takes a few seconds to collect the cells, which are then placed on a slide so they can be inspected under a microscope. If the test shows evidence of abnormal cells, your doctor might want to run an HPV test to follow up. Or you may need to undergo a biopsy.
Not every woman needs to undergo regular Pap test screening. Because cervical cancer is so rare in women under 21 years of age, the test may not be helpful. This screening test may also not be very useful in women who’ve undergone a hysterectomy or are older than 65 years, according to the National Cancer Institute.
However, the U.S. Preventive Services Task Force does recommend a test every three years for women between the ages of 21 and 29. For women between the ages of 30 and 65, the task force also recommends a test every three years or a high-risk human papillomavirus test (or co-test) every five years.
HPV is the most common sexually transmitted infection in the U.S., with about 79 million people currently infected. HPV is also responsible for nearly all cases of cervical cancer, according to the American Society of Clinical Oncology.
But if you’re under 45, you have the option of a vaccine that provides protection from the strains that cause more than 90 percent of HPV-related cancers. Gardasil 9, the HPV vaccine that’s currently on the market, is designed to prevent infection from nine strains of HPV that cause the majority of HPV-related cancers, including cervical cancer or precancerous or dysplastic lesions, as well as vulvar, vaginal, penile, and anal cancers.
The vaccine hasn’t been available to adults over 27 for very long. In 2006, the Food and Drug Administration (FDA) approved an earlier version of the vaccine for females, and then expanded it to include males in 2009. In 2018, the FDA expanded its approval to include adults between the ages of 27 and 45.
You may want to talk it over with your doctor before you roll up your sleeve; current guidelines do not specifically recommend vaccination for all adults in that age range, so you and your doctor should make that decision together.
Parents of children and teens, take note: the Advisory Committee on Immunization Practices (ACIP) does recommend HPV vaccination for younger people. The current recommendation is two doses before your child turns 15. Between the ages of 15 and 26, your child will need three doses of the vaccine to be considered fully vaccinated.
Other prevention strategies
The American Society of Clinical Oncology suggests a few other possible cervical cancer prevention strategies:
Avoid having sexual contact with someone experiencing an HPV infection
Limit your number of sex partners
If you have questions or concerns, it’s always a good idea to discuss them, as well as your own personal risk profile, with your healthcare provider.
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