Cervical cancer remains a pressing health issue, with an estimated 14,000 new cases diagnosed annually in the United States, and unfortunately leading to approximately 4,000 deaths
While these numbers are concerning, the good news is that cervical cancer is highly preventable and treatable when detected early.
Causes and risk factors
The primary cause of cervical cancer is the human papillomavirus (HPV), a common sexually transmitted infection. There are more than 100 variants of HPV, but only about 15 of them, when persistently present within the cervix, are known to cause cancer. The Centers for Disease Control and Prevention estimates that most people will contract at least one strain of HPV during their lifetime. Most of these exposures/infections resolve due to a woman's native immune system within two years; however, persistent infections with high-risk variants can lead to cervical cancer.
Several factors increase the risk of developing cervical cancer. The most important ones are cigarette smoking, a personal history of sexually transmitted infections and an increased number of sexual partners. Cervical cancer most commonly affects women aged 35 to 44, though more than 15 percent of cases occur in women over 65.
Early detection and symptoms
Cervical cancer often develops silently, with early stages typically presenting no symptoms. As the disease progresses, signs may include abnormal vaginal bleeding (excessive menstrual bleeding or pain between periods), unusual or malodorous discharge or pain during intercourse. These symptoms, however, are not exclusive to cervical cancer and can be caused by other conditions, underscoring the importance of regular screenings.
There are now two "Pap" tests (performed together or in sequence) that are considered standard for optimal early detection of pre-cancer and cancer of the cervix. Both are performed by testing material from the cervix during a pelvic examination. The traditional Pap is one of these - it identifies abnormal cellular changes in exfoliated cervical cells, while the HPV test detects the presence of one of the high-risk HPV strains mentioned above. Starting at age 25, the American Cancer Society recommends screening every five years with an HPV test, or a combined HPV and Pap test, until age 65.
Treatment options
Treatment for cervical cancer depends on factors such as tumor size, whether or not it has spread beyond the cervix and the patient's future pregnancy plans. Common treatments include surgery, chemotherapy and radiation therapy, used alone or in combination. Early-stage cervical cancer is usually curable, making timely diagnosis critical.
Prevention
The HPV vaccine is a powerful tool in preventing cervical cancer. It protects against the strains of HPV most likely to cause cancer. The CDC recommends vaccinating children aged 11-12, with a two-dose schedule spaced six months apart. Adults who missed vaccination during adolescence may still benefit. Eligibility often extends up to age 45.
In addition to vaccination, regular screenings are crucial in preventing cervical cancer or catching it in its earliest, most treatable stages. Maintaining a healthy lifestyle, avoiding smoking and practicing safe sex can also lower the risk.
Taking action
Don't wait to prioritize your health. Speak with a health care professional about scheduling your next screening or getting vaccinated against HPV. Together, these efforts can dramatically reduce the incidence of cervical cancer and empower more women to live healthier, cancer-free lives.
- John Moroney, MD, is a gynecologic oncologist with UChicago Medicine AdventHealth Medical Group in Hinsdale.
