When I read that almost 13,000 women are diagnosed yearly with a preventable
and treatable cancer, and one-third of them will die as a result, I can't
help but want to support raising awareness of it. So, since it is Cervical
Health month, I thought I would touch on some of the basics of cervical
health, and how it is not just a woman's issue.
What is cervical cancer?
As most of you are aware, cancer starts when cells in the body begin to
grow out of control. Cells in nearly any part of the body can become cancer
and spread to other areas. Cervical cancer starts in the cells lining
the cervix - the lower part of the uterus (sometimes called the uterine
cervix), which has two different parts, and therefore, is covered by two
different types of cells. The meeting place of these two parts is called
the transformation zone and is where most cervical cancers begin.
The cells in the transformation zone don't just suddenly turn into
cancer. The normal cells of the cervix first gradually develop pre-cancerous
changes that turn into cancer. Luckily, we have screenings, or Pap tests,
that can detect these pre-cancerous cells that can then be treated. In
the last 30 years, according to the American Cancer Society, the death
rate of cervical cancer has decreased by over 50%, mainly due to the increase
What causes cervical cancer?
While not all cervical cancers are linked to the human papilloma virus
(HPV) it is the most common cause. HPV is a large group of related viruses
that are segmented into low-risk and high-risk types. The low-risk types
tend to cause warts internally and externally on male and female reproductive
organs and areas around them. They rarely cause cancer and, therefore,
are considered low-risk.
High-risk types of HPV have been linked to cancer in both men and women.
Doctors worry about the changes and pre-cancers linked to these types
of HPV because they are more likely to cause cancer over time. They have
also been linked to vulvar, penile, anal, vaginal, and mouth and throat cancers.
How is HPV contracted?
HPV can be passed along from one person to another by skin-to-skin contact
with an infected part of the body, most often through sexual contact.
Often times there are no signs or symptoms of the virus for months, years,
or ever, once contracted.
Can HPV be prevented?
One the most amazing advances in recent health care is the ability to prevent
HPV related cancers by the HPV vaccination. According to the Centers for
Design Control, all children who are 11 or 12 years old should get two
shots of the HPV vaccine six to 12 months apart. A three-dose series is
recommended for adolescents who receive two shots less than five months
apart, kids 14 years or older, and those with certain immunocompromising
conditions aged 9 to 26.
Other preventative measures recommended by the American Cancer Society
for women include:
- Women should begin cervical cancer screenings at age 21. Women aged 21
to 29, should have a Pap test every 3 years. HPV testing should not be
used for screening in this age group (it may be used as a part of follow-up
for an abnormal Pap test).
- Beginning at age 30, the preferred way to screen is with a Pap test combined
with an HPV test every 5 years. This is called co-testing and should continue
until age 65.
- Another reasonable option for women 30 to 65 is to get tested every 3 years
with just the Pap test.
- Women who are at high risk of cervical cancer because of a suppressed immune
system (for example from HIV infection, organ transplant, or long term
steroid use) or because they were exposed to DES in utero may need to
be screened more often. They should follow the recommendations of their
health care team.
- Women over 65 years of age who have had regular screening in the previous
10 years should stop cervical cancer screening as long as they haven't
had any serious pre-cancers found in the last 20 years. Women with a history
of serious pre-cancers should continue to have testing for at least 20
years after the abnormality was found.
- Women who have had a total hysterectomy (removal of the uterus and cervix)
should stop screening, unless the hysterectomy was done as a treatment
for cervical pre-cancer (or cancer). Women who have had a hysterectomy
without removal of the should continue cervical cancer screening according
to the guidelines above.
- Women of any age should NOT be screened every year by any screening method.
- Women who have been vaccinated against HPV should still follow these guidelines.
- Additionally, men and women, both, are advised to consider abstinence,
safe sex (such as condoms), and avoid having many sexual partners to prevent
While these guidelines lay the foundation for cervical health, you should
always discuss all options with your healthcare team.
-- Tammy Osborn is an Advanced Nurse Practitioner with Blue Springs Internal
Medicine. She can be reached at 816-228-9841.