January was Cervical Health Awareness Month to encourage women to receive the human papillomavirus (HPV) vaccine if they’re eligible and get screened for cervical cancer.
Therefore, we will highlight issues related to cervical cancer, HPV disease and the importance of early detection.
Cervical cancer forms in the cervix, the lower, narrow part of the uterus that connects with the vagina. In the U.S. in 2013, there were about 12,000 new cases of cervical cancer and 4,000 deaths, according to estimates by the National Cancer Institute.
All women have a risk for cervical cancer, but it occurs most often in midlife, between age 35 and 55. However, about 20 percent of diagnoses are made in women aged 65 and older. Whatever your age, cervical cancer is almost always treatable and preventable when women adhere to cervical cancer guidelines secondary to improved screening and vaccination.
Risk factors for cervical cancer include HPV, smoking, young age at first pregnancy, diet and multiple sex partners at an early age. Other studies have suggested untreated chlamydia and persistent oncogenic HPV infection can also increase risk. Interestingly, a 2008 study found a diet rich in fiber, vitamins A, C, E, and a healthy serving fruits and vegetables was associated with 40 to 60 percent reduction in cervical cancer risk.
One key to the prevention of cervical cancer is vaccination. HPV is common among women and is the main cause of cervical cancer. In fact, HPV causes 99 percent of cervical cancer cases. There are many HPV types, but the most common high-risk HPV types that lead to cancer are HPV-16 and HPV-18.
About 14 million people, including teens, become infected with one or more types of genital HPV each year. In most cases, the virus will cause no symptoms or health problems and will go away on its own or become undetectable within two years. But in about 5 percent of women with the high-risk strains of HPV, a persistent infection may progress to cancer if untreated. Typically it takes 8-20 years for cervical cancer to develop after contact with high-risk HPV types.
The good news is that a human papillomavirus (HPV) vaccination can reduce the risk of infection by the high-risk HPV types (16 and 18) and even prevent many of the cervical cancers. In Australia, which has a vaccination program, the incidence of cervical dysplasia has decreased significantly. In the U.S., where vaccination rates and completion of the three doses are lower, it has decreased, but not as much.
Although, the vaccine provides strong protection against new HPV infections, they are not effective at treating established HPV infections or disease caused by HPV. Since the virus is shared during sexual contact, the vaccine should be given before a person becomes sexually active, at age 11-12. If your teen hasn’t gotten the vaccine, talk to their doctor.
The HPV vaccine is typically given in three doses over six months. In 2016, it was recommended that 11- and 12-year-olds receive only two doses of HPV vaccine at least six months apart rather than the previous three doses. Unacceptably, less than half of young women who are eligible for these vaccines have completed all three-dose series. Consequently, this year, there is a focus to increase the number of eligible women getting the HPV vaccine.
Cervical cancer screening is important because cancer usually takes years to develop. Moreover, because it causes no pain, it can go undetected, a fact that underscores the importance of regular Pap tests. Symptoms can include abnormal vaginal bleeding, unusual discharge, periods that last longer or have a heavier flow than usual, and bleeding after menopause.
Screening tests include the Pap test and testing for human papillomavirus (HPV). The Pap test looks at cells obtained from the cervix in order to identify cells that can lead to cancer.
The test is not 100 percent accurate, but regular Pap tests should identify changes in time for treatment.
A woman can also be tested for high-risk types of HPV. If not detected and treated early, cervical cancer can be more serious, even a fatal illness. The bottom line is to get tested regularly.
Pap smears usually start at 21 years of age and should be performed every three years until age 30, and then every five years until age 65. If a Pap smear shows abnormalities, follow-up is normally needed, including an HPV test and/or a biopsy of the cervix. However, testing for HPV is usually not recommended until the age of 30, since it is so common. If HPV is present after age 30, it is more concerning – as patients have not have made antibodies to fend off dysplasia/cervical cancer in the future.
For more information, contact your primary care provider or call 970-516-1616 to establish care.
