How to Detect and Prevent Cervical Cancer
Thanks to widespread screening, the incidence of cervical cancer has decreased significantly. Pre-cancer lesions can be detected and removed before they become malignant. In 2010, approximately 12,200 patients are estimated to be diagnosed with cervical cancer in the United States. An estimated 4,210 will die of this disease.
Screening tests include either conventional Pap smear or liquid cytology, with or without HPV (human papilloma virus) DNA test. The current recommendations from the American College of Obstetricians and Gynecologists for normal-risk women are as follows:
1) Pap smear to start at age 21
2) 3) > 30 years of age: every 3 years
4) Stop screening at age 65-70, after 3 normal tests during the last 10 years.
Screening is more frequent for high risk women. High risk conditions include previous cervical cancer, exposure to DES (diethylstilbestrol) as a fetus, and immunocompromised conditions (by organ transplantation drug, chemotherapy, steroids, or HIV). Please keep in mind that the screening recommendations above apply to “asymptomatic” patients. If you think that you have new symptoms, such as abnormal bleeding, unusual heavy discharge, pelvic pain, pain during urination, etc, discuss with your doctor.
With the recent development of vaccines, cervical cancer is now also a potentially preventable disease. The American Cancer Society recommends HPV vaccination for girls starting at age 11 up to 18. It is not yet clear whether vaccination for the age range of 19-26 is beneficial or not. The Gardasil vaccine prevents infection of four strains of HPV. Strains 16 and 18 cause 70% of cervical cancer cases and strains 6 and 11 cause 90% of genital warts cases. The Cervarix vaccine protects against HPV strains 16 and 18. Neither vaccine offers absolute prevention of all types of cervical cancer-causing HPV. Therefore, vaccinated women should still see their health care provider for routine cervical cancer screening. It should be noted that recently the FDA also approved the use of HPV vaccination for boys and men ages 9-26 for the prevention of genital warts.