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Cervical cancer - screening and prevention

Definition

Cervical cancer is cancer that starts in the cervix. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina.

There is a lot you can do to decrease your chance of having cervical cancer. Also, tests done by your health care provider can find early changes that may lead to cancer or find cervical cancer in the early stages.

Lifestyle and safer sex habits

Almost all cervical cancers are caused by HPV (human papilloma virus).

  • HPV is a common virus that is spread through sexual contact. The virus causes genital warts.
  • Certain types of HPV are more likely to lead to cervical cancer. These are called high-risk types of HPV.

HPV can be passed from person to person even when there are no visible warts or other symptoms.

Practicing safer sex can help reduce your risk of getting HPV and cervical cancer:

  • Always use male and female condoms. But be aware that condoms cannot fully protect you. This is because the virus or warts can also be on the nearby skin.
  • Have only one sexual partner, who you know is infection-free.
  • Limit the number of sexual partners you have over time.
  • Do not get involved with partners who take part in high-risk sexual activities.
  • Not smoking also makes a difference. Cigarette smoking increases the risk of getting cervical cancer.

Vaccines to Prevent Cervical Cancer

Two vaccines are available that protect against the HPV types that cause most cervical cancer in women:

  •  The vaccine is given as a series of three shots.
  • It is recommended for girls and women ages 9 through 26.
  • It is best for girls to receive the vaccine by age 11 or before becoming sexually active. However, girls and younger women who are already sexually active can still be protected by the vaccine.

Pap Smears

Cervical cancer usually develops slowly. It starts as precancer changes called dysplasia. Dysplasia can be detected by a medical test called a Pap smear.

Dysplasia is 100% treatable. This is why it is important for women to get regular Pap smears.

Pap smear screening should start at age 21. After the first test:

  • Women ages 21 through 29 should have a Pap smear every 3 years.
  • Women ages 30 through 65 should be screened with either a Pap smear every 3 years or a Pap smear and HPV test every 5 years.
  • If you or your sexual partner has other new partners, you should have a Pap smear every 3 years.
  • Women ages 65 through 70 can stop having Pap smears as long as they have had three negative tests within the past 10 years.
  • Women who have been treated for precancer (cervical dysplasia) should continue to have Pap smears for 20 years after treatment or until age 65, whichever is longer.

Talk with your health care provider about how often you should have a Pap smear.

References

American Academy of Pediatrics, Committee on Infectious Diseases. Policy Statement: HPV vaccine recommendations. Pediatrics. 2012. DOI: 10.1542/peds.2011-3865.

Centers for Disease Control and Prevention. Advisory Committee on Immunization Practices (ACIP) Recommended Immunization Schedules for Persons Aged 0 Through 18 Years and Adults Aged 19 Years and Older — United States, 2013. MMWR. 2013;62(Suppl1):1-19.

Noller KL. Intraepithelial neoplasia of the lower genital tract (cervix, vulva): etiology, screening, diagnostic techniques, management. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 28.

Saslow D, Solomon D, Lawson HW, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin. 2012;62(3):147-72.

U.S. Preventive Services Task Force. Screening for cervical cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012;156:880-91.


Review Date: 11/9/2013
Reviewed By: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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