A Q&A with Leda Portia Gattoc, MD
Q: Can cervical cancer be prevented?
Dr. Gattoc's response:
A recent international study of 66 million men and women under age 30, published in 2019 in The Lancet medical journal, found that the human papillomavirus (HPV) vaccine significantly reduced precancerous changes in the cervical cells of girls and young women. Another recent study found that the incidence of cervical cancer in young women dropped significantly a few years after the vaccine was introduced. HPV vaccination is recommended for both boys and girls ages 11-12, but it can be administered through age 26 if they were not vaccinated prior. In some cases, adults aged 27-45 years of age can also consider getting the vaccine after discussion with their physicians.
This is very good news, as all three vaccines available in the market protects against the two types of HPV that are responsible for most cases of cervical cancer. One of the vaccines (Gardasil) also protects against HPV strains (6 and 11) that cause a majority of genital warts, and the most recent vaccine (Gardasil 9) protects against an additional 5 cancer causing HPV strains (31, 33, 45, 52, and 58).
More than 13,800 American women are diagnosed with invasive cervical cancer each year, and about 4,290 women a year die from it. There is mounting evidence that this cancer can be prevented, and longstanding evidence that precancerous changes (dysplasia) and early cancer can be detected and kept from progressing if treated in time.
Cervical cancer is usually diagnosed between the ages of 35 and 44 with the average of diagnosis at the age of 50. Screening guidelines in the United States recommend initiating cervical cancer screening with a pap smear at the age of 21 and repeating the test every 3 years if normal up to the age of 30. Starting at age 30, HPV testing can be performed along with the Pap test every five years. If there is persistent presence of high risk HPV strains found with repeat testing, then additional monitoring may be performed. A physical exam, pelvic exam and personal/family health history should also be done at each visit with your ob/gyn.
It is important to know some of the symptoms that can be found with cervical cancer. They may include abnormal or irregular vaginal bleeding, vaginal discharge and/or pain during sex. These symptoms may not necessarily mean a diagnosis of cancer, but see your physician as soon as possible if you have them. More importantly, it is important to follow the guidelines and start the appropriate screening tests as recommended. If you have an abnormal pap smear, it is even more important to continue close follow up with your physician to avoid progression into cervical cancer. If cervical cancer is diagnosed early, the chance for cure is high and more recently, novel treatment modalities such as immunotherapy and targeted therapy have improved our ability to treat this highly morbid but preventable disease.