What is cervical cancer and how do you prevent it?

In In The News by Barbara Jacoby

By: Dr. Alex Larson, Ogden Clinic

From: ksl.com

No woman should die of cervical cancer because, with early detection, it is among the most preventable types of cancer. Dr. Alex Larson, an OB/GYN at Ogden Clinic, talks about what causes cervical cancer and how it can be prevented.

What is cervical cancer and what causes it?

The narrow opening from the uterus to the vagina, called the cervix, is covered with flat, thin cells called squamous cells. Most cervical cancers (about 90 percent) are caused by mutations in squamous cells. The best defense against cervical cancer is regular screening for abnormalities of the cervix, including the presence of human papillomavirus (HPV).

How is HPV related to cervical cancer?

Human papillomavirus (HPV) is found in over 90 percent of all cervical cancers. There are over 100 strains of HPV and most of them not cancer-causing (called low-risk HPV). However, a handful of HPV strains is considered high-risk because they can cause cell abnormalities or cancer. HPV-16 and HPV-18 are the “hard-hitters” of high-risk strains.

HPV is acquired through skin-to-skin contact, most often passed through sex. It’s extremely common for men and women to acquire some type of HPV in their lifetime. In fact, approximately 80 percent of women have been infected by some type of HPV by age 50, but the majority of them do not develop cervical cancer. Regular screenings for high-risk HPV and other preventative measures are our best defense against cervical cancer.

What is the screening schedule for HPV?

Regular screenings during your well-woman visits are the most important thing you can do to prevent cervical cancer. These are the current ASCCP guidelines for cervical cancer screenings:

Age 21 – 29: Pap tests begin routinely

A Pap test looks for any abnormal cells on the cervix that could lead to cancer if untreated. If the Pap test comes back normal, it’s good for three years. If abnormal cells are detected, they may be DNA-tested for the presence of high-risk HPV strains.

Beginning at age 30: Pap and HPV tests are performed routinely

The Pap test looks for cell changes caused by HPV while the HPV test looks for the virus itself, specifically types that are linked to cervical cancer. Cervical cancer is slow-growing, meaning that it tends to develop as a woman ages. The goal of testing for HPV at age 30 is to catch the progression of high-risk HPV cells. Pap and HPV co-testing continue every five years for most women.

Do HPV vaccines prevent cervical cancer?

We expect they will. Estimates are that we will see the effects of vaccination on cervical cancer rates about 20 years from when vaccination began (we’re nearly 10 years into that time). The better we are at widespread vaccination, the greater the expected decrease in cervical cancer rates. There are currently three HPV vaccines available that have been proven safe and well-tolerated. All vaccines protect against HPV-16 and HPV-18, dangerous strains which account for 70 percent of all cervical cancer cases. Two HPV vaccines, Gardasil® and Gardasil 9® also protect against low-risk strains including those that cause genital warts.

If I have received the HPV vaccine, do I still need routine Pap/HPV screening?

Yes, women who have received an HPV vaccine are currently treated the same as women who haven’t when it comes to Pap and HPV screening. The vaccine does not prevent against all HPV types that can lead to cervical cancer.

Is there anything else you would like to add about cervical cancer prevention?

Most often, I tell my patients to stay calm if they become infected with HPV. Most strains of HPV are low-risk, and even if a woman acquires a high-risk strain, her chances of developing cervical cancer are very low if she and her OB/GYN keep an eye on the virus’s course with regular visits and resolve any dysplasia, or abnormal cell activity, early before it has the chance to get worse.