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Ask The Expert: Cervical Cancer

January 31, 2019

Nana Tchabo, MD

Nana Tchabo, MD is a gynecologic oncologist at the Women's Cancer Centers at Atlantic Health System's Morristown and Overlook medical centers.

What is cervical cancer and are there ways to prevent it?

As we observe Cervical Health Awareness Month, it's important to know some basic facts about cervical cancer and how to prevent it.

More than 13,000 American women are diagnosed with cervical cancer each year, and about 5,000 will die from it. Yet, we have effective ways to detect cervical cancer early and, often, to cure it -- or to prevent it from developing in the first place.

  • Cervical cancers that are caught in their earliest stages have a very high likelihood of being cured. It is among the most slow-growing types of cancer, so early detection can really make a difference. Cervical cancer usually starts between the ages of 35 and 44, but is important to start screening earlier so that any precancerous changes can be found and addressed.

  • The Pap smear has been around for many years and it remains a key weapon in the fight against cervical cancer. This test can detect both cancer and precancerous changes in the cervix's cells. Current recommendations are for most women to get a Pap smear every three years, starting at age 21.

  • Precancerous cells found by the Pap test, known as dysplasia, are generally found in women under age 30. Having cervical dysplasia does not necessarily mean you will get cancer. If your doctor finds these cells, however, additional tests, and possibly treatment, may be done and you will have to be closely monitored.

  • Cervical cancer is caused by the human papilloma virus (HPV), as well as by behaviors such as smoking. Seventy percent of cases of cervical cancer are caused by one of two strains of the virus: HPV 16 and HPV 18. We now have HPV tests that can identify whether either of these virus strains is present.

  • Starting at age 30, HPV testing is now recommended in addition to the Pap smear. If you are between 30 and 65, your physician may perform an HPV test of cervical cells, along with the Pap test, every five years. As with the Pap test, additional tests and ongoing monitoring will often be done if HPV 16 or HPV 18 are found. Screening is generally not done after age 65, but there are exceptions. Every woman is different, so speak with your doctor about which tests you should get, and how often.

Another key prevention tool is the HPV vaccine, generally given by primary care providers or pediatricians. Both the American Academy of Pediatrics and Centers for Disease Control & Prevention recommend that an HPV vaccine be given to all girls and boys between the ages of 11 and 12. Girls as young as age 9 can now get the HPV vaccine, and women (and men) as old as 45 may benefit from the Gardasil 9 HPV vaccine if they did not receive it earlier. While the vaccine is not 100-percent effective against all strains of HPV, it is effective against HPV 16 and HPV 18.

It is also important to know the warning signs of cervical cancer. These include abnormal or irregular vaginal bleeding, vaginal discharge and/or pain during sex. These symptoms do not necessarily mean cancer, but you should be checked out if you have them. And remember that many cervical cancers can be effectively treated, so don't be afraid to speak with your doctor if you have symptoms of this sort.

Good sources for more information on cervical cancer are the American Cancer Society and the National Cervical Cancer Coalition.

Remember: prevention and early detection are key.