Here's everything you need to know about cervical cancer

From early detection to treatment options, we dive into the full conversation

HOUSTON – Cervical cancer was once the most common cause of cancer deaths in American women, however over the past 40 years that number has significantly dropped.

In 2019 alone, more than 13,000 new cases of cervical cancer were diagnosed and over 4,000 women died from cervical cancer in the United States, making it the third most common gynecologic cancer, however the 2nd most common cancer diagnosed in women worldwide.

With the advent of PAP tests, the cervical cancer death rate has dropped significantly.

Q: What is the root cause of cervical cancer?

  • Greater than 99% of cervical cancer is caused by the Human papillomavirus or HPV.  Most women will be exposed to HPV during their lifetime, however it only results in cervical cancer in a small number of infected women.  
  • There are many types of HPV, however there are only a handful that are known to be oncogenic (cancer causing).
  • Most HPV infections are transient, but when it persists, it can cause cervical dysplasia and eventually cancer if not treated.
  • So the risk factors for cervical cancer are those that increase the risk of acquiring HPV or having a compromised immune response to HPV, such as early onset of sexual activity, multiple sexual partners, history of sexually transmitted disease, history of cervical dysplasia, etc.

Q: Is Cervical Cancer genetic?

  • There is no well-established data for genetic basis for cervical cancer.  
  • However there are studies being done to identify genetic alterations that may make a women less likely to clear a persistent HPV infection.

Q: What are symptoms of cervical cancer?

  • Early cervical cancer is frequently asymptomatic but can be discovered during screening examination or a pelvic examination.
  • Most common symptoms include irregular or heavy vaginal bleeding, postcoital bleeding and vaginal discharge.
  • Advanced disease cancer can present with pelvic or back pain, radiating pain to the lower extremities, bowel or bladder symptoms.

Q: How can cervical cancer be detected?

  • Screening can detect precursors and early-stage cancer.  More than 50% of women who develop cervical cancer were not screened appropriately.
  • Screening initially started with just PAP tests and now there is an addition of testing for high-risk strains of HPV.
  • Screening starts at the age of 21 years with PAPs.  Patients that are 30 years and older can also get HPV testing in conjunction with their PAP tests.  
  • Discontinuation of screening can occur from the age of 65-75 years old, depending on what guidelines are followed and if they have had adequate screening with normal results.  Which means, over the past 10 years, PAPs and/or HPV testing have been normal.  
  • If a woman has had a history of cervical dysplasia, screening should be continued to guidelines.
  • If a woman has had a hysterectomy for reasons that were not due to cervical dysplasia or cancer, such as fibroids, they do not need PAP tests.  However, knowing what type of hysterectomy that was performed may be beneficial.  Such as a hysterectomy that the cervix was not removed will still require PAP and/or HPV testing according to guidelines.  
  • Despite not needing annual PAP or HPV testing per guidelines, every woman should get annual pelvic examinations.

Q: Can cervical cancer be prevented?

  • Yes! The HPV vaccination can protect against acquisition of HPV infection and therefore the development of cervical cancer.
  • In the United States the 9 valent vaccine is available and targets 9 types of HPV that are mostly associated with cervical cancer, as well as anal, oropharyngeal, vulvar, vaginal and penile cancers.
  • The vaccination was approved for girls and boys from the age of 9 to 26 years old.  However, in the fall of 2018, the FDA approved the vaccination up to the age of 45 years old.  So, to all the individuals that missed the vaccination, including myself, we can still receive it!  Insurance has not still caught up and has not started covering it up to the age of 45 years old, but it is on the forefront.  
  • Individuals that have had cervical dysplasia or HPV infections should still receive the vaccination as well.  
  • There are estimates of 65% less cases of cervical cancer and deaths worldwide if there were vaccination rates of 70% worldwide.  Australia is already set to be the first country in the world to eliminate cervical cancer secondary to their successful HPV vaccination program.  So, get vaccinated!


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