Cervical cancer is the third most common gynecological cancer in the U.S. The other main types are ovarian, uterine, vaginal and vulvar cancers. Each year, 12,000 new cervical cancer cases are diagnosed in the U.S. and a third of women diagnosed will die from the disease. The good news is that cervical cancer is one of the most preventable types of cancer. It is also highly curable when diagnosed and treated early.
“In the past 50 years, there has been a 75% reduction in this type of cancer in the U.S., thanks to the fact that many women get regular gynecological exams and Pap tests,” says Anna Komorowski, M.D. medical oncologist and Acting Director of Northwell Health Cancer Institute at Phelps Hospital. The Pap test detects pre-cancerous cells in the cervix. A Pap test is recommended every three years for women 21-29 and every three to five years for women 30-65.
All women are at risk for cervical cancer, although it occurs most often in women between the ages of 35 and 55. “It’s a slow- growing cancer, so if caught early it can be treated and prevented from developing into an invasive cancer,” says Komorowski.
What Causes Cervical Cancer?
The human papillomavirus (HPV) is the main cause of cervical cancer. In fact, 96-99% of cervical cancer is associated with HPV. HPV is a common virus that is passed from one person to another during sex by genital- to-genital or genital-to-anal contact (even without penetration). Condoms can reduce HPV transmission to females, although condoms protect only the skin they cover.
There are about 100 types of HPV viruses, but only 15 are considered high risk. Of these, subtypes 16 and 18 cause about 70%
of cervical cancers. If you can get rid of HPV, you can eliminate the chances of developing cervical cancer.
“When a woman is exposed to and infected with HPV, the body’s immune system can usually get rid of it. But if there
is a persistent HPV infection, especially with high-risk types of HPV, the cells in the cervix can become increasingly abnormal and develop into cervical cancer,” says radiation oncologist May Lim, M.D., Physician-in- Chief of the Phelps Hospital Department of Radiation Medicine and a member of Northwell Health Physician Partners. It can take weeks, months or years after exposure to HPV before the virus is detected.
Other risk factors for cervical cancer include, smoking; behavioral factors such as starting sexual activity early in life, having multiple sexual partners or partners who have multiple sexual partners; and having HIV or another condition that causes depression of your immune system.
What Are the Symptoms of Cervical Cancer?
It is important to note that women with pre- cancer or very early stages of cervical cancer may not have any symptoms. The most common symptoms of cervical cancer are abnormal bleeding, abnormal vaginal discharge, pain during intercourse or pelvic pain. Even if you have had a Pap smear that is negative, you should follow up with your doctor if you have any of the symptoms described above, and further diagnostic tests may be prescribed.
Treatment
Treatment for cervical cancer depends on the stage of the cancer. “If cancer is in the very early stage, surgery may be an option, or a combination of radiation therapy and chemotherapy may be used,” says Lim.
For later stage cancer, radiation therapy and chemotherapy are usually given. After either kind of treatment, it is important for patients to continue to follow up with their doctors regularly as instructed to detect any recurrences or manage any side effects.
How to Prevent Cervical Cancer?
The best way to prevent cervical cancer is to get vaccinated for HPV at a young age. HPV vaccines, which are administered in several doses, can help prevent infection from both high-risk HPV types that can lead to cervical cancer and low-risk types that cause genital warts. Current guidelines recommend the HPV vaccine for preteen boys and girls starting at age 11 or 12, but young women can get the vaccine through age 26 and young men can get it through age 21. It is also recommended through age 26 for any man who has sex with men or has a compromised immune system. “Thanks to increased routine HPV vaccination, the rate of HPV and cervical cancer will dramatically decrease,” says Komorowski.
It’s also important for women to have routine screening throughout life by going for routine gynecological exams and Pap tests until they’re in their 70s. Effective screening can detect early signs of pre-cancerous changes and stop them from developing into invasive cancers.
Phelps Hospital, part of Northwell Health, is a full-service, 238-bed acute care community hospital located in Sleepy Hollow, NY.
The more than 1,700 employees and 500 medical staff members represent 60 medical specialties. www.phelpshospital.org. Phelps’ primary and specialty care medical group, Phelps Medical Associates, has nearly 20 practices located on the hospital campus
and in the surrounding communities. www.phelpsmedicalassociates.org
