How Can You Prevent Cervical Cancer?
Cervical cancer is one of the most preventable types of cancer for these reasons:
It has risk factors that are within your control.
It has a recommended screening test in the Pap test, which can find the cancer early or in precancerous stages.
Two vaccines are available for girls and young women. They are also available for boys and young men.
The most important risk factor for cervical cancer is having certain types of the human papillomavirus (HPV), one of the most common sexually transmitted diseases in the United States. More than 100 strains of HPV have been identified, but only about 30 can be transmitted through sexual contact and only about 15 are implicated in cervical cancer and the condition that precedes it, cervical intraepithelial neoplasia grade 3. All strains of HPV cause non-cancerous warts.
HPV is most common in women and men in their late teens and early 20s. At least 50 percent of sexually active men and women acquire genital HPV infection at some point in their lives.
HPV is usually transmitted through vaginal, oral, or anal sexual intercourse with a person who has the virus. It can also be transmitted through contact that does not involve penetration of the anus or vagina. Because genital warts may not always be present or visible, it's impossible to tell just by looking if a person has genital HPV. Also, a person may not know he or she has HPV, because there may be no symptoms.
Most HPV infections go away on their own within months to a few years and don't cause cancer. If the infection does not clear up on its own, it takes years to progress to the precancerous stage or to invasive cancer. Experts think that other factors also must be present for cancer to develop.
Preventing HPV is a major step toward preventing cervical cancer. Two vaccines are available to protect against HPV. Both are given as a series of three injections given over a six-month period. They protect against HPV strains 16 and 18, which cause about 70 percent of cervical cancers, and one also protects against types 6 and 11, which cause about 90 percent of genital warts.
The vaccines are effective only if given before an infection with HPV, so one of them should be given before a girl or woman becomes sexually active. The vaccines are recommended for all girls between ages 11 and 12, and girls as young as age 9 can receive the vaccine; girls and women 13 to 26 years old who have not received the vaccine should be allowed to catch up on vaccination. The vaccine is not routinely recommended for women older than 26 or for boys or men.
Because the vaccines are new, experts don't know how long they will continue to offer protection. Studies so far, however, have shown that the vaccines continue to be effective against HPV 16 for four years.
Condoms, if used correctly and consistently, also may help protect you from getting HPV. The virus, however, can be spread through skin-to-skin contact with any infected part of the body, including the skin in the genital area that cannot be covered by a condom.
Importance of Pap tests
If you are already infected with one of the covered HPV strains, the HPV vaccine cannot protect you from the effects of that strain, although it will protect you against the others that are covered. The vaccines also will not protect against infection with HPV strains 31, 45, or the others that can also cause cervical cancer. Because of these reasons, regular Pap tests are still important.
Pap tests can detect precancerous changes in the cells of the cervix before they become cancer. They can also detect cervical cancer in its early stages, when it can be treated most easily. So getting regular Pap tests gives you a better chance of preventing cancer. Occasionally, the pelvic exam that is often done along with Pap tests can also help detect some cancers of the uterus and other parts of the female reproductive system.
Women should have yearly Pap tests starting either at age 21 or within three years of becoming sexually active, whichever comes first. Testing should be done every year using the regular Pap test or every two years using the newer liquid-based Pap test, the American Cancer Society (ACS) says. After three or more normal results, and depending upon your risk factors, your doctor may recommend that you have Pap tests every two to three years. If you have gone through menopause, you still may need to have a Pap test.
Other risk factors
Although HPV infection is the main risk factor for cervical cancer, not all women with HPV get this cancer. The ACS says that other risk factors may be involved that increase the chances of developing cervical cancer:
Smoking. Smoking doubles the risk for cervical cancer, the ACS says.
HIV. Although the virus that causes AIDS is different from HPV, it still raises the risk for cervical cancer.
Chlamydia. Chlamydia is another sexually transmitted disease (STD). Some studies have found a connection between this infection and increased risk for cervical cancer.
Diet and weight. Women who are overweight or eat a diet low in fruits and vegetables seem to be at higher risk for cervical cancer.
Oral contraceptives. The ACS says that using birth control pills for five or more years puts a woman at higher risk for cervical cancer, but the risk goes down again over time after the pills are stopped.
Many children. A woman who has had many full-term pregnancies is at higher risk.
Poverty. Women of low income are at greater risk, possibly because they cannot afford good preventive health care.
Family history. Having a mother or sister with cervical cancer puts you at higher risk.