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Cervical cancer was one of the most common causes of cancer death among women worldwide several decades ago. This situation significantly improved over time however, primarily due to the use of Pap tests – a screening procedure that can find changes in the cervix before cancer develops.

Risk Factors

Infection by the Human Papilloma Virus (HPV) – a very common virus – is the most important risk factor for cervical cancer. Most sexually active individuals will have HPV infection at some point. It is transmitted through sexual contact (oral, genital or anal) with an infected partner. HPV is usually harmless, most people have no symptoms of HPV infection and most are cleared by the body in a year or two.

Some types of HPV may cause genital warts (HPV types 6 and 11) and cervical lesions (HPV type 16 and 18) which over a period can develop into cervical cancer if undetected.

Other things can increase your risk of cervical cancer:

  • Smoking: Studies have shown that women who smoke are twice as likely to have cervical cancer as opposed to non-smokers.
  • Having HIV or another condition that makes it hard for your body to fight off health problems such as autoimmune diseases and after an organ transplant.
  • Using birth control pills for a long time (five or more years).
  • Having given birth to three or more children.
  • Having several sexual partners.

Screening

Cervical cancer is preventable if precancerous cell changes are detected and treated early. This is done with regular screening through:

– Pap Smear/Test
A test to find abnormal cell changes on the cervix before they turn into cancer. A small brush or cotton tipped applicator is used to take a sample of the cervical cells. These cells are then examined for abnormal cell changes.

– HPV Test
This test can detect “high-risk” types of HPV which lead to cervical cancer and help healthcare providers know which women are at greater risk.

When to get tested?

It is recommended that women aged 21-29 years should have Pap test every 3 years.

Women 30-65 years should have a Pap test and an HPV test (co-testing) every 5 years (preferred) although it is acceptable to have Pap test alone every 3 years.

Women should stop having cervical cancer screening after age 65 if they do not have any history of cervical cell changes or cancer. In addition, if they have had either three negative Pap test results in a row or two negative co-test results in a row within the past 10 years, with the most recent test within the past 5 years, then they need no further screening.

HPV Vaccines

There are currently two HPV vaccines available in the market namely:

– Gardasil: for both males and females, is close to 100 % effective at preventing infection associated with HPV types 6,11,16 & 18.

– Cervarix: vaccine just for women, is also close to 100% effective in preventing infection associated with HPV 16 &18.

It is recommended that ALL females between the ages of 9 to 26 get an HPV vaccination.

The majority of women diagnosed with cervical cancer either have never had a Pap test or did not have one in the last five years. Cervical cancer is completely preventable if precancerous cell changes are detected and treated early, before cervical cancer develops.

Dr. Hazel Gallardo-Paez - Family and Community Medicine, Family Medical Practice Danang