January is Cervical Cancer Awareness Month, and it’s a good time to talk about one of the most preventable cancers there is. Cervical cancer is the fourth most common cancer in women worldwide, yet with vaccination, regular screening and prompt treatment, most cases can be stopped before they ever start.
What is cervical cancer?
Cervical cancer begins when cells in the cervix start growing out of control. The cervix is the lower part of the uterus that connects to the vagina (birth canal). According to the American Cancer Society, these cancers usually develop slowly. Before cancer appears, cells in the cervix go through precancerous changes that can be found and treated.
The role of HPV
According to the World Health Organization (WHO), human papillomavirus (HPV) is responsible for more than 95% of cervical cancer cases. HPV is the most common viral infection of the reproductive tract, and most sexually active people will get it at some point in their lives.
The good news is that the immune system clears most HPV infections on its own, usually within a year or two. When an infection with a high-risk type of HPV lingers, though, it can slowly cause precancerous changes. In women with healthy immune systems, it typically takes 15 to 20 years for cervical cancer to develop. For women with weakened immune systems, such as those living with untreated HIV, it can happen in as little as five to 10 years.
Other risk factors
- Smoking, which makes it harder for the body to clear HPV
- A weakened immune system
- Not being screened regularly
- Long-term use of birth control pills (the risk drops after stopping)
- Having had many full-term pregnancies
Prevention, step 1: HPV vaccination
The HPV vaccine is the most powerful tool for preventing cervical cancer. Studies show it prevents HPV infections, high-grade precancerous changes and invasive cancer. It works best when given before a person is ever exposed to the virus, which is why it’s recommended for preteens. In the U.S., routine vaccination is recommended at age 11 or 12 and can begin as early as 9. Catch-up vaccination is recommended through age 26, and some adults up to 45 may benefit after talking with their doctor. Boys are vaccinated too, since HPV also causes other cancers.
Prevention, step 2: Screening
Vaccination doesn’t replace screening. Screening finds HPV infections and precancerous changes early, when they’re easy to treat, and it can catch cancer at an early stage when the chance of a cure is high.
Recommendations vary by country and organization. In the U.S., screening generally starts in your 20s with a Pap test, an HPV test or both, repeated every three to five years depending on the test and your age. The WHO recommends HPV-based screening starting at age 30 for most women, and at 25 for women living with HIV, who should also be screened more often. Your provider can tell you which schedule is right for you.
Symptoms to watch for
Early cervical cancer often causes no symptoms, which is why screening matters. When symptoms do appear, they can include:
- Bleeding or spotting between periods
- Bleeding after sex
- Bleeding after menopause
- Increased vaginal discharge, sometimes with a bad smell
- Pelvic pain or pain during sex
What this means for you
- Check your screening status. If you can’t remember your last Pap or HPV test, ask your provider whether you’re due.
- Vaccinate your kids. Ask your pediatrician about the HPV vaccine at the 11- or 12-year-old checkup.
- Ask about catch-up shots. If you’re 26 or younger and weren’t vaccinated, it’s not too late.
- Don’t ignore unusual bleeding. Get it checked, even if your last screening was normal.
- Quit smoking. It lowers your risk of cervical cancer and many other diseases.
The bottom line
Nearly all cervical cancer is caused by HPV, and it can largely be prevented. The HPV vaccine and regular screening are the two most effective steps you can take.
This article is for general information and isn’t medical advice. Talk with your healthcare provider about your individual needs.
