Every year, around 11,500 new cases of cervical cancer are diagnosed in the U.S. While cervical cancer used to be one of the most common causes of cancer death for U.S. women, the vaccine against the human papillomavirus (HPV), and increased early screening and detection have resulted in a decrease in rates.
“Cervical cancer is almost always preventable and typically diagnosed in patients who have either never had a screening test or have gone many years without one,” says Fred Wyand, director of communications at the American Sexual Health Association, which includes the National Cervical Cancer Coalition.
January is Cervical Cancer Awareness Month, so we spoke to experts to learn more about what it is, its symptoms, and what you can do to prevent it.
What is cervical cancer?
Cervical cancer is a type of cancer that starts in the cervix—the lower part of the uterus that connects the vagina to the uterus. Cervical cancer can affect anyone with a cervix but is most frequently diagnosed in women ages 35 to 44, according to the American Cancer Society.
There are two types:
- Squamous cell carcinoma: Cervical cancer that starts in the thin squamous cells on the outside of the cervix. This is the most common type of cervical cancer.
- Adenocarcinoma: Cervical cancer that starts in glandular cells that line the inside of the cervix. This type of cervical cancer is less common.
In some cases, cervical cancer has features of both types.
What causes cervical cancer?
Almost all cases of cervical cancer are caused by high-risk cases of HPV, a virus that is spread through sexual activity or other close skin-to-skin contact. But don’t panic: HPV is very common, and getting HPV doesn’t always mean you’ll get cervical cancer. Around 85 percent of people in the U.S. will get an HPV infection in their lifetime, but for most people, the virus clears on its own.
However, there are many strains of HPV, and some are linked to cervical cancer. In those cases, when the virus does not clear on its own and the HPV infection persists, it can cause a range of cancers in both men and women, including cancers of the cervix, anus, penis, throat, and vagina.
That’s why HPV vaccination is so important for all people: It can help prevent many types of cancer, including cervical cancer caused by those high-risk HPV infections.
What are the symptoms of cervical cancer?
Cervical cancer doesn’t usually have symptoms in its early stages, but once cancer begins to spread, the symptoms can include:
- Vaginal bleeding between periods, after sexual intercourse, or after menopause.
- Heavier and longer menstrual periods than usual.
- Vaginal discharge that has a strong odor and is watery.
- Pelvic pain or pain during sexual intercourse.
In more advanced stages, symptoms of cervical cancer can include:
- Leg swelling.
- Difficult or painful bowel movements or bleeding during a bowel movement.
- Blood in urine or difficulty urinating.
- Back pain.
“Most women present with no symptoms,” Dr. Kristina A. Butler, gynecologic oncologist at Mayo Clinic, tells PGN. “Therefore, the checkups with visualization of the cervix, speaking with your provider, and having a Pap smear are so important.”
How can you help prevent or reduce your risk for cervical cancer?
Vaccination: Cervical cancer is highly preventable. The most effective way to help protect yourself from it is by getting the HPV vaccine. The HPV vaccine is most effective before a person is first exposed to HPV, typically before becoming sexually active.
“If we are able to vaccinate children before they become adults [and] are subsequently exposed, those individuals are maximally protected against the [worst effects] of the virus, which could ultimately be cancer,” Butler adds.
You’re eligible to get the vaccine if you’re between 9 and 45 years old, but there are specific guidelines for each age group. The Centers for Disease Control and Prevention recommends HPV vaccination for children ages 11 or 12 (though it can start at 9 years).
The CDC says that you can get catch-up doses until you’re 26 if you didn’t get vaccinated earlier, but if you’re between 26 and 45 years old, you should talk to your health care provider about your individual risk for HPV and to see if you should get the vaccine.
Screenings: This is another effective way to prevent cervical cancer.
Dr. Deanna Gerber, a gynecologic oncologist at NYU Langone’s Laura and Isaac Perlmutter Cancer Center, tells PGN that regular screenings can catch HPV before it has a chance to become cancer.
“Now that we’re encouraging people to see their gynecologist and get screening more regularly, we’re catching cancer at earlier stages,” she says.
Screenings for cervical cancer include:
- Pap smear: During a Pap smear, also known as a Pap test, cells are collected from your cervix to find precancerous or cervical cancer cells. Pap smears should start at 21 years old, regardless of when you start having sex.
If you’re between 21 and 29, you should get a Pap smear every three years. If you’re 30 to 65 years old, it’s recommended you get one every three years, a Pap and HPV test together every five years, or an HPV test alone every five years.
- HPV test: During an HPV test, cells are collected from your cervix to look for infection with high-risk HPV strains that can cause cervical cancer. If you’re between 21 and 30 years old, it’s only recommended that you get an HPV test if you had an abnormal Pap smear result. After 30, an HPV test is recommended with a Pap smear every five years, as long as other results were normal.
(People over 65 years old should talk to their health care provider about whether they need screening.)
Not smoking: Avoiding smoking can reduce your risk of developing cervical cancer because “HPV and smoking tobacco work together to accelerate the negative effects of HPV,” says Gerber.
Wearing condoms: Although condoms don’t completely prevent HPV infection, they provide some protection. And according to the CDC, the use of condoms has been associated with a lower rate of cervical cancer.
There is hope with early detection
There is hope for people diagnosed with cervical cancer. “Compared to the survival [rates] 10 years ago, women survive much longer now with the great treatments we have,” adds Butler.
Some of those treatments and advances include radiation, chemotherapy, and surgical therapy.
And while there may be some stigma surrounding sexual health, it’s important to advocate for yourself, says Gerber.
“Being comfortable and bold talking to your doctor about your health or any concerns that you have, feeling comfortable with your provider by asking all these questions is really the best thing you can do.”
For more information, talk to your health care provider.