Human papillomavirus (HPV) is found in about 99% of cervical cancers. There are more than 100 different types of HPV, the majority of which are considered low risk and do not cause cervical cancer. High-risk HPV types may cause cervical cell abnormalities or cancer. More than 70% of cervical cancer cases can be attributed to two types of the virus, HPV-16 and HPV-18, often referred to as high-risk HPV types.
2. What are the symptoms of cervical cancer?
Precancerous cervical cell changes and early cancers of the cervix generally do not cause symptoms. Abnormal or irregular vaginal bleeding, pain during sex, or vaginal discharge may be symptoms of more advanced disease. Notify your health-care provider if you experience:
- Bleeding between regular menstrual periods
- Bleeding after sexual intercourse
- Bleeding after douching
- Bleeding after a pelvic exam
- Pelvic pain not related to your menstrual cycle
- Heavy or unusual discharge that may be watery, thick, and possibly have a foul odor
- Increased urinary frequency
- Pain during urination
3. How do you diagnose cervical cancer?
The best way to determine if precancerous or cancerous cells are present is with a Pap test. In addition, your doctor may recommend an HPV test. The HPV test does not indicate the presence of precancerous or cancerous cells; it determines whether or not a woman has an HPV infection with any of the 13 high-risk HPV types. The test cannot tell you whether your infection is new or if it is persistent. This information will assist you and your doctor to determine appropriate follow-up and intervals for cervical cancer screening.
4. What is a Pap test?
The Pap test (sometimes called a Pap smear) is a way to examine cells collected from the cervix (the lower, narrow end of the uterus). The main purpose of the Pap test is to find abnormal cell changes that may arise from cervical cancer or before cancer develops.
5. What do abnormal results mean?
A physician may simply describe Pap test results to a patient as "abnormal." Cells on the surface of the cervix sometimes appear abnormal but are very rarely cancerous. It is important to remember that abnormal conditions do not always become cancerous, and some conditions are more likely to lead to cancer than others. A woman may want to ask her doctor for specific information about her Pap test result and what the result means.
6. How often should a woman have a Pap test?
Women should talk with their clinician about when and how often they should have a Pap test. Current general guidelines recommend that women have a Pap test at least once every three years, beginning about three years after they begin to have sexual intercourse, but no later than age 21. Experts recommend waiting about three years after the start of sexual activity to avoid overtreatment for common, temporary abnormal changes. Cervical cancer, which usually develops slowly, is extremely rare in women under age 25.
Women ages 65 to 70 who have had at least three normal Pap tests and no abnormal Pap tests in the last 10 years may decide, after talking with their clinician, to stop having Pap tests. Women who have had a hysterectomy (surgery to remove the uterus and cervix) do not need to have a Pap test, unless the surgery was done as a treatment for precancer or cancer.
7. Are there any ways to prevent cervical cancer?
Cervical cancer is one of the most preventable cancers. If caught early, the five-year survival rate is almost 100%. Regular Pap testing is the best method to protect against invasive cervical cancer. It is important to remember that cervical cancer takes many years to develop. Regular Pap tests will, with luck, help detect any precancerous or abnormal cells early enough so that cervical cancer can be prevented.
In addition to routine Pap testing, you may want to consider minimizing risk factors that could contribute to cervical cancer. Those factors include:
- Multiple sexual partners
- Multiple full-term pregnancies
- Sexual intercourse at an early age
- Chlamydia infection
- Cigarette smoking
- Use of oral contraceptives
- Weakened immune system or HIV infection
8. What are the treatment options available for cervical cancer?
The treatment of cervical cancer depends more on the severity of the disease (the stage) than the cell type. In the United States, the majority of cervical carcinoma patients are diagnosed with early stage disease.
Among women with the earliest stage (Stage lA1 or micro-invasive) of cervical cancer, a simple hysterectomy is generally recommended. Usual treatment of patients with stage lA2 and lB1 lesions consists of either radical hysterectomy with bilateral pelvic lymph node dissection or radiation therapy (RT), which combines two kinds of therapywhole pelvic teletherapy and local brachytherapy (implants). These treatments work well at resolving lesions that are small and when the cells have not yet metastasized. Surgery is often preferred to radiation therapy in younger women because ovarian function is eliminated (bringing on a kind of menopause) and sexual function is often difficult following RT.
9. I've heard about the HPV vaccine. Does it protect against cervical cancer?
Yes, HPV vaccine is the first vaccine developed to prevent cervical cancer. This new vaccine is highly effective in preventing HPV infection, the major cause of cervical cancer in women. The vaccine protects against four types of HPV, including two that cause about 70% of cervical cancer.
Content provided by the National Cervical Cancer Coalition.