No woman should die of cervical cancer
Each year, approximately 12,000 women in
the United States find out they have cervical cancer and ~4000 die. Cervical cancer is almost always caused by
high-risk/oncogenic types of human papillomavirus (HPV). Although HPV is a common virus that is
easily transmitted during sex, most women who have been infected with HPV clear
the virus on their own. Those that do
not clear oncogenic types of the virus are at increased risk for developing
cervical, vaginal, vulvar and anal cancers.
Other factors that increase a woman’s
risk of cervical cancer are smoking, HIV infection, long-term use of oral
contraceptives and having multiple children.
However, cervical cancer is highly preventable if cancer precursors are found early and treated, and cervical
cancer has the best chance of being cured when found and treated at the stage before
it has spread (carcinoma in situ).
Cervical cancer screening is one of the greatest cancer
prevention achievements. So why do some
women still develop or die from this disease?
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| Pap Test |
Most women know they should get Pap tests, but they may not know why or
how Pap tests work. The Pap test (or Pap
smear) samples the epithelial lining of the cervix. These samples are examined by a trained
cytologist who looks for cellular abnormalities associated with HPV (minor
abnormalities called dysplasias and more significant abnormalities known as precancers). Pap tests are usually recommended for women
between 21 and 65 years of age.
However, according to the CDC, in
2012, the percentage of women who had not been screened for cervical cancer in
the past 5 years was estimated to be 11.4%; the percentage was higher for women
without health insurance (23.1%) and for those without a regular health care
provider (25.5%). These women are at the
highest risk for developing and dying from cervical cancer.
Advances in Screening
Beginning in 2003, HPV DNA tests
were licensed for use:
- in conjunction with Paps in women 30 years of age and older
- as a follow-up test if abnormal Pap results were observed in women aged 21 years and olderBoth Pap and DNA test are also used to determine how often a woman needs to be screened; this can vary from every 6 months to every 5 years depending on individual circumstances.
Stay tuned!
In April 2014, one of these DNA
tests, the cobas HPV Test, was approved for stand-alone use (without Pap) as
first-line cervical cancer screening in women aged 25 years or older. This means that professional guidelines for
the use of Pap tests and HPV tests may be in the process of changing soon.
Primary Prevention Through Vaccination
Vaccines are also available to help
protect against the types of HPV that most often cause cervical cancer. These vaccines are recommended routinely for
both boys and girls at age 11 or 12.
For more information about cervical cancer and its prevention
Judith Wolf, MD
Associate Director, WHEP
