Public awareness has decreased the number of women who suffer from cervical cancer, but even more women can avoid the disease by practicing safe sex and making early detection a priority. Human papilloma virus (HPV) infection is a chief risk factor associated with cervical cancer and is transmitted sexually. The other major contributing factor is avoidance of preventive screening tests. About 65-70 percent of women diagnosed with cervical cancer haven’t followed the recommended screening guidelines.

The cervix (the mouth of the womb) is a narrow opening at the lower portion of the uterus (womb) that connects to the vagina. Cervical cancer occurs when abnormal cells in the area begin growing uncontrollably.

Cervical cancer can often be linked to intercourse before age 18 and “high-risk” behaviors at a young age, which include unprotected sex (without condoms) and multiple partners. People who smoke and who have immunosuppressive diseases are also at higher risk.

Since birth control pills were introduced, young women’s attitudes toward sex have changed. Birth control pills protect against pregnancy, but they don’t protect against dangerous sexually transmitted diseases, like chlamydia, gonorrhea, HIV and other infections.

According to the National Cancer Institute, the human papillomavirus (HPV) is the most common sexually transmitted infection. HPV is a family of more than 100 viruses that can cause abnormal tissue growth. Certain types of HPV (type 16 and 18) may increase a woman’s risk of developing cervical cancer.

Cervical cancer grows slowly and it may take years to develop, so it’s important to detect it early at the precancerous stage, before the abnormal cells turn into cancer. With proper treatment, we can treat almost 100 percent of lesions before they become cancerous.

Each year in the United States alone, more than 3 million women are diagnosed with cervical abnormalities. However, even if the abnormal cells have already developed into early-stage cancer, cervical cancer is still one of the most treatable types of cancer.

The American Cancer Society estimates that more than 11,070 new cases will be diagnosed and 3,870 will die from cervical cancer in 2008. The disease is most common in women over 40. Patients who have early-stage invasive cervical cancer have a five-year survival rate of between 85 and 92 percent. For advanced-stage cancer, the survival rate is less than 10 percent.

Expert Recommendations

Experts recommend the following steps for prevention and early detection of cervical cancer:

• Practice responsible, safe sex.

  Women who have sexual intercourse before age 18, who do not use barrier contraceptives and who have had more than three sexual partners are at greater risk for developing an HPV infection and cervical cancer.

  Birth control pills and spermicidal gels may offer some protection, but they do not completely protect against sexually transmitted diseases. To be safe, it is recommended to use a diaphragm in conjunction with the pill.

• Make early detection a priority.

  Whether or not they are sexually active, all women under age 65 should have an annual pelvic exam and a cervical cytology test, commonly known as a Pap test. The physician collects a small sample of cells from the surface of the cervix, which are then examined under a microscope for suspicious changes.

  If the physician detects precancerous cell changes, known as dysplasia, he or she will recommend further testing, which may include a colposcopy, which is a procedure that uses a microscope to examine the surface and inside of the cervix. He or she may take a tissue biopsy for accurate diagnosis. Most precancerous changes are found in women who have had regular Pap tests.

• Kick the smoking habit.

  According to the U.S. Preventive Services Task Force, cigarette smoking has been consistently correlated with cervical cell abnormalities and cancer, at minimum doubling, and in some cases quadrupling, a woman’s risk for the disease.

  Ceasing to smoke also will improve your overall health, since the habit has been linked to heart disease, lung cancer and vascular problems.

Patients with early-stage cervical cancer typically have no symptoms. If symptoms do appear, the cancer has probably spread to other parts of the body. First signs of disease may include spotting or bleeding, often following intercourse, and foul-smelling discharge. The individual may also experience abdominal pain, problems while urinating or defecating and swelling of the legs.

Any of these symptoms can also be caused by noncancerous gynecologic problems, so it’s important to consult your physician when they occur.

HPV Vaccination

Prophylactic HPV vaccines in clinical trials have demonstrated up to 100% efficacy against persistent HPV infection and the development of cervical lesions. Clinical trial data indicates that vaccine protection is maintained over 4.5 – 5 years. Presently, two types of vaccines are available commercially for immunization- quadrivalent and bivalent HPV vaccines, which are given at 0, 1 and 6 months intervals.

Recommendations from the Advisory Committee on Immunization Practice (ACIP) for the HPV vaccine are:

• The vaccination series can be started in girls as young as 9 years of age at the discretion of the health provider.
• A catch-up vaccination is available for adolescents and young women 13-26 years of age who have not been previously vaccinated.

The American Cancer Society (ACS) recommends vaccination of females 11-18 years of age. The American College of Obstetricians and Gynecologists (ACOG) recommend that females between 9-26 years of age receive the vaccination.

This article originally appeared in UC Health Line (1/3/06), a service of the NetWellness.org Academic Health Center Public Relations Department and was adapted for use on NetWellness with permission, 2006.

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