The cervix is an organ that we only think about when something goes wrong with it! It is the passage between the vagina and the uterus. Among other things, it’s also a barrier that keeps vaginal bacteria out of the uterus itself and it “holds the baby in” when a woman is pregnant. It acts like an important support point within the pelvis for other pelvic organs. However, when we think of cervical health, the first thing that comes to mind for most people is cervical cancer.
Tragically, about 12,000 women in the United States are diagnosed with cervical cancer every year and it occurs most often between the ages 35 and 55. This cancer is 64% more likely among Hispanics and 34% more likely among African Americans than among Caucasians. Smoking is definitely linked with a higher chance development of cervical cancer. Many of the symptoms of cervical cancer (bleeding, discharge and pelvic pain) are also common signs of other health issues, so it can be overlooked for quite some time.
Cervical cancer isn’t the most common cancer in women but it does have a relatively high mortality rate thanks to its ability to go undetected until it is very advanced. Early detection is the key; it’s very curable when found and treated early. Over ninety percent of women diagnosed in the earliest stage of cancer will survive, but by the time the cancer has spread to other areas of the body the survival rate is quite low.
HPV is a very common viral infection that spreads through sexual activity, and it causes 99% of the cases of cervical cancer. Most people with HPV don’t know they are infected. Precancerous cervical cell changes do not cause symptoms at all. The virus strains that lead to cancer are considered to be the higher risk strains, but there are over 100 different types of HPV.
Once the cervix has been infected, the virus can change the cells of the cervix in a direction that can lead to cancer. Luckily, it is usually a very slow process, taking many months to years. Cervical cancer screenings can help detect abnormal cells early, before they turn into cancer. The Pap smear screening looks for precancers, which are cell changes on the cervix that might become cervical cancer if they are not treated appropriately The HPV test looks for the DNA of the virus that can cause these cell changes. The two tests are frequently done together.
Almost all of deaths from cervical cancer could be prevented by regular screenings and follow-up care. These simple screening tests are recommended for women between ages 21 and 65, and they can be done in a doctor’s office. Women should start getting Pap tests regularly at age 21, or earlier if there are multiple sexual partners. The screening interval is up to the physician and it might be influenced by recommendations from professional societies. If test results are normal, the chances of getting cervical cancer until the next screening is low.
It used to be that sexually active women would have Pap screening annually. Less frequent screening recently has inadvertently led to a decrease in STD screening as well. The good news is that when problems are detected by routine screening in the precancer stage, it is almost unheard of to have progression of the precancers to actual cancer.
Vaccines are now available to protect against the types of HPV that most often cause cervical cancer. The Gardasil 9 HPV currently vaccine currently gives the most protection against cervical cancer for girls and women. It is almost always covered by insurance. This HPV vaccine protects against the specific strains of HPV that most often cause cervical, vaginal, and vulvar cancers. HPV vaccines are approved for girls and young women from 9 through 26. Experts recommend that all girls get an HPV vaccine before any sexual activity, preferably by the time they are 11 or 12.