September is Gynecologic Cancer Awareness Month and physicians at Atrium Health Navicent encourage the community to talk to their health care providers about the most common types of gynecologic cancers as well as treatment options.
Gynecologic cancers are cancers of the female reproductive system, and all women are at risk for developing one of these cancers. According to the National Cancer Institute, in 2023 more than 106,000 women in the United States will be diagnosed with a gynecological cancer, and more than 32,000 will die from gynecological cancer.
There are five main types of gynecological cancer – cervical cancer, ovarian cancer, uterine cancer, vaginal cancer and vulvar cancer, each with different signs and symptoms, as well as different risk factors.
“It’s imperative that women stay current on their well-woman visits and gynecological exams to help detect gynecological cancers early, when treatment is easiest and most effective,” said Dr. Vincent Fang, an Atrium Health Navicent OB-GYN. “It’s also important to be on the lookout for symptoms such as bleeding or discharge that’s not normal for you, or pain or pressure in the pelvis. While these symptoms may, or may not be signs of cancer, you should call your doctor right away.”
Cervical Cancer
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.
According to the American Cancer Society (ACS), about 13,000 new cases of cervical cancer are diagnosed each year in the United States and about 4,000 women die of this cancer. Hispanic women have the highest rates of developing cervical cancer, and Black women have the highest rates of dying from cervical cancer.
Screenings for the human papillomavirus (HPV) and Pap smear tests are available for cervical cancer. Almost all cervical cancers are caused by HPV, a common virus that can be passed from one person to another during sex. The HPV test looks for the virus, which can cause cell changes on the cervix. The Pap test looks for precancers, which are cell changes on the cervix that might become cervical cancer if they are not treated appropriately.
Screening recommendations include:
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.
A HPV vaccine is also available and recommended for children, young adults and some adults up to age 45.
Ovarian Cancer
According to the ACS, ovarian cancer ranks fifth in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system. A woman's risk of getting ovarian cancer during her lifetime is about 1 in 78.
Women at a higher risk for ovarian cancer are over 40 years old, have close family members who have had ovarian cancer, have endometriosis, have never given birth or have a genetic abnormality called BRCA1 or BRCA2, or one associated with Lynch syndrome.
Although there are no reliable screening tests for ovarian cancer, annual appointments with your gynecologist can lead to early detection and treatment. It’s important to talk to your doctor if you have one or more of the following symptoms:
Vaginal bleeding (particularly if you are past menopause) or vaginal discharge that is not normal for you.
Pain or pressure in the pelvic area.
Abdominal or back pain.
Bloating.
Feeling full too quickly, or difficulty eating.
A change in your bathroom habits, such as a more frequent need to urinate, or constipation.
Uterine Cancer
Uterine cancer is the most common gynecologic cancer in the United States. The ACS estimates that in 2023, about 66,200 women will receive a new diagnosis of uterine cancer, resulting in 13,030 deaths. The most common type of uterine cancer, endometrial cancer, affects mainly post-menopausal women. The average age of women diagnosed with endometrial cancer is 60.
Several factors may increase the chance that you will get uterine cancer, including if you:
Are older than 50.
Are obese.
Take estrogen by itself (without progesterone) for hormone replacement during menopause.
Have had trouble getting pregnant, or have had fewer than five periods in a year before starting menopause.
Take tamoxifen, a drug used to prevent and treat certain types of breast cancer.
Have close family members who have had uterine, colon or ovarian cancer.
Have a genetic mutation such as BRCA1 or BRCA2, or one associated with Lynch syndrome.
Vaginal and Vulvar Cancers
Vaginal and vulvar cancers are very rare, accounting for about 7 percent of all gynecologic cancers diagnosed in the U.S. Risk factors include having an HPV infection, having cervical precancer or cancer, having a condition that weakens your immune system such as HIV and having a history of smoking.
Talk to your doctor right away for you are experiencing any of these symptoms of vaginal cancer:
Vaginal discharge or bleeding that is not normal for you.
A change in bathroom habits, such as having blood in the stool or urine, going to the bathroom more often than usual, or feeling constipated.
Pain in your pelvis, especially when you pass urine or have sex.
Symptoms of vulvar cancer include:
Itching, burning or bleeding on the vulva that does not go away.
Changes in the color of the skin of the vulva, or the appearance of what looks like a rash or warts.
Sores, lumps or ulcers on the vulva that do not go away.
Pain in your pelvis, especially when you urinate or have sex.
Atrium Health Navicent Women’s Care OB/GYN offers a wide range of gynecological services for patients ranging from teenagers through menopause. Appointments are available in Macon and Forsyth. To schedule an appointment call 478-633-1821. Gynecological exams are also available on-campus for students, faculty and staff at Central Georgia Technical College and Fort Valley State University.
Atrium Health Peyton Anderson Cancer Center provides cancer treatment and survivorship services for patients diagnosed with a variety of cancers, including gynecological cancers. If you or a loved one has concerns about cancer risk factors, available screenings or cancer care, contact Atrium Health Navicent Peyton Anderson Cancer Center at 478-633-3000. To find a doctor, visit NavicentHealth.org and click “Find A Doctor.”
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