January is National Cervical Cancer Awareness Month and doctors at Atrium Health Navicent invite the community to help raise awareness about cervical cancer by encouraging women to make their annual gynecology visits a priority.
The American Cancer Society (ACS) has estimated about 14,100 new cases of invasive cervical cancer would be diagnosed in the United States in 2022, leading to about 4,280 deaths. Hispanic women have the highest rates of developing cervical cancer, and Black women have the highest rates of dying from the disease.
Cervical cancer is most frequently diagnosed in women between the ages of 35 and 44. Many older women don’t realize that the risk of developing cervical cancer is still present as they age. More than 20 percent of cases of cervical cancer are found in women over 65.
Early on, cervical cancer may not cause apparent signs and symptoms. Advanced cervical cancer may cause abnormal bleeding or discharge from the vagina, such as bleeding after sex. If you have any of these signs, see your doctor. The signs and symptoms may be caused by something other than cancer, but the only way to know for sure is to see your doctor.
“It’s so important for women to keep their annual visits with their OB/GYN. Each exam includes a review of your medical history, routine vitals, a breast exam, palpation of the abdomen and lymph nodes, and then a pelvic exam, if indicated. Routine labs are normally ordered to monitor liver functions, cholesterol and possibly hormone levels. In other words, an annual visit to your OB/GYN could identify something going on in your body before it becomes serious,” said Dr. Adrienne Jones, an Atrium Health Navicent OB/GYN.
While cervical cancer was once one of the most common causes of cancer death for American women, the mortality rate dropped significantly with increased use of the Pap smear test, according to the ACS. The screening procedure can detect changes in the cervix before cancer develops and can also identify cervical cancer early, when it's easier to treat.
The Centers for Disease Control (CDC) has issued guidelines for cervical cancer screenings, including Pap smear tests and screenings for human papillomavirus (HPV). They are broken down by age:
If you are 21 to 29 years old: You should start getting Pap tests at age 21. If your Pap test result is normal, your doctor may tell you that you can wait three years until your next Pap test.
If you are 30 to 65 years old: Talk to your doctor about which testing option is right for you:
A Pap test only. If your result is normal, your doctor may tell you that you can wait three years until your next Pap test.
An HPV test only. This is called primary HPV testing. If your result is normal, your doctor may tell you that you can wait five years until your next screening test.
An HPV test along with the Pap test. This is called co-testing. If both of your results are normal, your doctor may tell you that you can wait five years until your next screening test.
If you are older than 65: Your doctor may tell you that you don’t need to be screened anymore if:
You have had normal screening test results for several years; or
You have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids.
“Cervical cancer is preventable with appropriate screening and surveillance. A Pap smear finds changes in cells of the cervix that can indicate future cancer. Regular screenings will show these cell changes and allow for early prevention or intervention,” Jones said.
There are several important things you should do when preparing for your Pap or HPV test. You should not schedule your test for a time when you are having your period. If you are going to have a test in the next two days:
You should not douche (rinse the vagina with water or another fluid).
You should not use a tampon.
You should not have sex.
You should not use a birth control foam, cream or jelly.
You should not use a medicine or cream in your vagina.
The Role of HPV in Cervical Cancer
Almost all cervical cancers are caused by human papillomavirus (HPV) infection. HPV is a common virus that can be passed from one person to another during sex. There are many types of HPV. Some HPV types can cause changes on a woman’s cervix that can lead to cervical cancer over time, while other types can cause genital or skin warts.
According to the ACS, HPV is the leading cause of cervical cancer, and almost 35,000 men and women are diagnosed with HPV cancers in the United States every year. HPV is so common that most people get it at some time in their lives. HPV usually causes no symptoms, so you can’t tell that you have it. For most women, HPV will go away on its own; however, if it does not, there is a chance that over time it may cause cervical cancer.
Studies have shown that giving the HPV vaccine to boys and girls aged 9 to 12 can prevent more than 90 percent of HPV cancers as children grow older.
“I absolutely believe that increased HPV vaccinations can prevent cases of cervical cancer and I agree with all of the CDC’s guidelines about the importance of getting vaccinated against HPV,” Jones said. “According to the CDC, 85 percent of people will get an HPV infection in their lifetime. HPV vaccination provides safe, effective and long-lasting protection. And preventing cancer is always better than treating it.”
The CDC has offered recommendations for HPV vaccines:
HPV vaccine is recommended for routine vaccination at age 11 or 12 years. (Vaccination can be started at age 9.)
Vaccination is also recommended for everyone through age 26, if not adequately vaccinated when younger. The vaccine is given as a series of either two or three doses, depending on age at initial vaccination.
Some adults ages 27 through 45 years may decide to get the HPV vaccine based on discussion with their doctor, if they did not get adequately vaccinated when they were younger.
“The HPV vaccination works best before exposure to the virus, so the earlier one is vaccinated, the more beneficial,” Jones said. “Most people 26 or older have been exposed, so the vaccine typically provides little benefit. There are new guidelines that indicate people age 27-45 can receive the HPV vaccination if their physician feels they are at risk for new exposure to HPV.”
Facts About HPV Vaccination
Because many people may feel apprehensive about vaccinations, the CDC offers these facts about the HPV vaccine.
The HPV vaccine works best when administered to children aged 9 to 12. Since vaccines are used to help prevent diseases, children are vaccinated before being exposed to an infection. Most people in the U.S. are exposed to HPV in their teens, so it’s best to get the vaccine before then.
The HPV vaccine is for boys and girls. HPV is so common that almost everyone (at least 8 out of 10 people in the U.S.) will come in contact with it at some point in their lives. HPV leads not only to cervical cancer, but also to cancers of the throat, vulva, vagina, penis and anus.
The HPV vaccine is safe and lasts a long time. The HPV vaccine has been used since 2006, and went through extensive safety testing before becoming available. More than 270 million doses of the HPV vaccine have been given worldwide. Like with any vaccination, there may be common mild side effects that go away quickly like headache or fever. Once your child has the vaccine, current research shows that there’s no sign the vaccine protection lessens with time.
While HPV is the leading risk factor for cervical cancer, other risk factors include having HIV (the virus that causes AIDS) or another condition that makes it hard for your body to fight off health problems; smoking; using birth control pills for a long time (five or more years); having given birth to three or more children; and having several sexual partners.
“There are three things women should do to help prevent cervical cancer: get the HPV vaccine, get regular cervical cancer screenings (Pap smears) and if sexually active, use condoms correctly to protect against exposure to sexually transmitted diseases,” Jones said.
Atrium Health Navicent offers OB/GYN care in Macon and Forsyth. For more information, and to find a doctor, visit NavicentHealth.org.
For information about services available at the Atrium Health Navicent Peyton Anderson Cancer Center, ranging from prevention and diagnosis to treatment and survivorship, call (478) 633-3000.
For more information about well-child visits and recommended immunizations, visit navicenthealth.org/service-center/children-s-health.