By Dr. Grace Chen O'Neil, Tripler Army Medical CenterJanuary 31, 2019
HONOLULU (Jan. 31, 2019) - With 79 million Americans currently infected with the Human Papillomavirus, or HPV and 11,000 women diagnosed in the U.S. with cervical cancer, Cervical Health Awareness Month was created to raise awareness about how women can protect themselves with vaccination and appropriate screenings.
Cervical cancer is cancer that starts in the cervix and is almost always caused by HPV. Many people with HPV are asymptomatic, but the infection is found in 99 percent of cervical cancers.
With more than 100 different types of HPV, most are low risk and do not cause cervical cancer, but there are about 12 high-risk HPV types that are transmitted sexually. These sexually transmitted HPV types also cause most anal, vaginal, vulvar, penile, and oral cancers. More than 70 percent of cervical cancer cases are caused by HPV-16 and HPV-18 (high-risk HPV types).
HPV is the most common sexually transmitted infection in the U.S. By age 50, about 80 percent of women have been infected with a type of HPV, but most of them do not get cervical cancer because most HPV infections resolve on their own within two years. A small percentage of women do not clear HPV and have a persistent infection which leads to a higher risk of having cervical cancer.
HPV infections can cause cellular changes, though most infections are eventually suppressed by the immune system before causing cancer. If cervical infection with high-risk HPV persists, the cellular changes can develop into more severe precancerous lesions. Untreated precancerous lesions can progress to cancer. Persistent infections may take 10-20 years to develop into cancer.
It is imperative for women to schedule a regular cervical screening test called the Papanicolaou, or Pap smear test because cervical cancer can often be prevented with regular screenings and follow-up care. The Pap test allows for early detection and treatment of cervical cell abnormalities. When abnormal tissue or cancer is found early, it can be easier to treat because by the time symptoms occur cancer may have already spread elsewhere in the body.
Most women who have cervical cell changes that progress to cervical cancer never had a Pap test or have not had one in the last three to five years. Cervical cancer is most frequently diagnosed in women 35-44 years old. Cervical cancer screening involves both a Pap smear and HPV testing. The Pap smear detects abnormal cells, and the HPV testing looks for high-risk HPV types in the cervical cells.
Also, the HPV vaccine can prevent HPV and protects against the seven different HPV types that are responsible for most cervical cancers.
Therefore, it is especially important that women have a Pap test at the recommended intervals. Every woman should ask their health care provider how often she should be screened and which tests are right for her. Generally, if you are between 21-30 years old, guidelines state you should have a Pap smear every three years as long as it is normal. If you are 30-65, then you can have a Pap smear every five years as long as you have HPV testing with it.
For more information about preventing cervical cancer and HPV, visit the Centers for Disease Control and Prevention at https://www.cdc.gov/cancer/cervical.