January is Cervical Health Awareness Month. This presents a good opportunity for the question: How much do you know about cervical cancer and how to prevent it?
Most women undergo regular Pap smears, but you may not know or appreciate why we recommend you undergo the test. The Pap smear, which has been used since 1928, is a common screening test that helps detect cervical cancer.
Take a few minutes to read up on cervical cancer, including what causes it and what you can do to prevent it. Your health will thank you.
Defining cervical cancer
Cervical cancer is a type of cancer that develops in the cells of the cervix, the bottom portion or opening of the uterus. The American Cancer Society estimates that nearly 14,000 new cases of cervical cancer were diagnosed in 2023 alone, including nearly 500 in Georgia.
While that may seem like a lot of new cases diagnosed, the condition was much more common until recently. Cervical cancer rates dropped by more than half between the mid-1970s and the mid-2000s.
This wonderful decrease in a preventable cancer occurred largely because more women are now screened regularly for cervical cancer. Regular screening allows us to detect precancerous cells before they develop into cancer. When caught early in the precancerous stage, worrisome cells can be removed.
The other reason for the decrease in the number of cervical cancer cases is the emergence of the HPV vaccine. The human papillomavirus, or HPV, is responsible for the majority of cervical cancers—and anyone who has ever been sexually active has likely been exposed to HPV.
In fact, up to 90% of sexually active people will develop HPV at some point in their lives. In most cases, HPV clears from the body on its own thanks to your immune system, but the virus can sometimes hide and result in abnormal precancerous cells.
The symptoms of cervical cancer
Cervical cancer is slow to develop, often forming over a period of many years. Early-stage cervical cancer may not cause any symptoms at all, and it can be easily detected during routine screenings.
When symptoms are present, they may include:
- Pelvic pain during sex
- Periods that are longer or heavier than usual
- Vaginal bleeding after menopause
- Vaginal bleeding after sex
- Vaginal bleeding between periods
- Watery, smelly, or bloody vaginal discharge
When cervical cancer spreads and moves out of the cervix in later stages, it can cause symptoms that affect other parts of the body, including painful bowel movements or urination, back pain, leg swelling, abdominal pain, weight loss, or extreme fatigue.
If you develop any of these symptoms, talk to your OB/GYN or another women’s health provider about what you’re experiencing. Because symptoms typically develop as cervical cancer spreads and worsens, don’t wait to have things checked out. The sooner you see your provider, the better.
How cervical cancer is diagnosed & treated
Cervical cancer is diagnosed using cervical cancer screening, which is a preventive health exam recommended for most women. This exam should consist of both a pap smear and a visual exam of your cervix. During a Pap smear, also called a Pap test, a swab is used to collect cells from the cervix. These cells are then placed under a microscope to identify abnormal cells.
This screening test detects both precancerous cells and cervical cancer cells, along with abnormal cells caused by infection and inflammation. If abnormal cells are detected during a routine screening, further testing, like a colposcopy and biopsy, may be recommended.
A cervical biopsy takes a more in-depth look at a sample of cervical tissue looking for precancerous changes, known as cervical intraepithelial neoplasia (CIN). The results of this test will determine whether treatment is needed. This is also commonly called dysplasia.
In many cases, mild CIN/dysplasia changes will resolve on their own without treatment. Moderate CIN/dysplasia changes need careful follow up and consideration of treatment. Severe dysplasia, or CIN 3, requires treatment since it can become cancer if left untreated.
Treatment for CIN 3 or for known cancer vaires depending on a number of factors, including whether a woman wants to become pregnant after treatment. Cervical precancer treatment can include LEEP (loop electrosurgical excision procedure), which uses electrical current to remove abnormal tissue, or conization, which uses a scalpel to remove abnormal tissue. Cervical cancer treatment can include a hysterectomy done in either a minimally invasive fashion or abdominal incision surgery. Cervical cancer treatment can also include using radiation and chemotherapy to completely treat the cancer without a need for surgery.
What you can do to prevent cervical cancer
We’ve never been more equipped to prevent cervical cancer than we are now. Through routine cervical cancer screenings and HPV vaccination, many cases of cervical cancer can be prevented.
Since most cases of cervical cancer are caused by HPV, being vaccinated against the virus is an important part of prevention. The HPV vaccine is recommended as a two-dose regimen for children ages 11 and 12. This includes both boys and girls since HPV is also associated with other types of cancer.
Teens and young adults can also receive the vaccine. Those who get the vaccine after their 15th birthday should receive three doses of the HPV vaccine for full protection. You can get the vaccine up through age 26, and it may even have some effectiveness in adults ages 27 to 45.
It’s also important to have regular screenings, even if you have had the HPV vaccine. Along with routine Pap smears, HPV testing may be recommended as a replacement for a Pap smear or in addition.
The U.S. Preventive Services Task Force recommends getting a Pap smear to screen for cervical cancer every three years between ages 21 and 29. The task force recommends that those between ages 30 and 65 continue having a Pap smear every three years or have an HPV test every five years or cotest with both a Pap smear and an HPV test every five years.
That can seem confusing, but the takeaway is actually quite simple: It’s important to be screened for cervical cancer, so talk with your provider about the screening that will be best for your specific needs.
The team of gynecologic oncology experts at Northeast Georgia Medical Center can provide comprehensive, advanced care for cervical cancer, including precancerous cells. Call 770-525-4736 or click here for more information.