“Cervical cancer is one of the most preventable and treatable forms of cancer.” – The American College of Obstetricians and Gynecologists (ACOG)
During an annual Gynecologic exam, your doctor may recommend that you get a Pap smear and HPV test to screen for cervical cancer. The Pap test, along with testing for the Human Papilloma Virus (HPV) is the best way for your doctor to screen you for potential precancer or cancer of the cervix. This is just one way that Ob-Gyns are trained to screen for cervical cancer, one of the most preventable and treatable forms of cancer. Let’s talk about the facts, diagnosis, treatment, and prevention of one of the most common gynecologic cancers.
The Facts
The American Cancer Society estimates that for 2022, in the United States:
~ 14,100 new cases of invasive cervical cancer will be diagnosed
~ 4,280 women will die from cervical cancer
Cervical cancer develops from the growth and proliferation of abnormal cells on the cervix, most commonly due to infection with HPV. While this type of cancer was once one of the deadliest cancers for American women, we have seen a significant decrease in cases and death rates within the US. This trend is due to the increased use of screening measures like the Pap smear and HPV testing, as well as the use of HPV vaccines for prevention.
It’s been encouraging to see incidence rates trending down and survival rates trending up over time and we hope that these trends continue as we make advances in prevention, screening, and treatment.
Human Papilloma Virus
The most common cause of cervical cancer is HPV. Infection with high-risk types of HPV leads to the majority of precancerous and cancerous lesions of the cervix. HPV is a common and easily communicable virus that is transmitted by skin to skin and sexual contact. In recent history, the development of HPV vaccines has been one of the most exciting innovations in the field of gynecology. There is a real chance that it could help to eradicate the most common types of cervical cancer, which are those related to high-risk HPV infection.
While not everyone who has HPV will develop cervical precancer or cancer, it is important to be screened as recommended by your doctor so you can catch and treat any abnormalities early if they occur. Let’s talk about cervical cancer screening.
Screening
Before a cervical cancer develops, normal cells slowly undergo abnormal changes and develop into precancerous lesions. If left unchecked, some of those precancerous lesions may then undergo further change into cancerous cells.
Not all precancerous lesions will become cervical cancer. Some will resolve without treatment, while others can be removed before they become cancers. This is only possible if they are first identified on screening tests. If precancerous or early cancerous lesions on the cervix are identified, they are usually treatable and curable.
Current ACOG guidelines recommend screening for cervical cancer starting at age 21. Screening tests include pap testing which examines a sample of cells from the cervix, as well as testing for high-risk types of HPV. Which combination of tests and the intervals at which those tests should be done are determined based on individual risk factors.
Diagnosis
If a person has an abnormal screening test, their provider may then recommend that they have a follow-up diagnostic test called a colposcopy. For this test, the provider uses a microscope to identify any abnormal cells on the cervix and may take a sample of the cells. That sample is then sent to a pathologist who can examine it and determine the degree of abnormality in the cervical cells. Based on the pathology result, the provider will then recommend a treatment and follow-up plan.
Typically, colposcopies are done in your Ob-Gyn’s office. Patients can expect mild discomfort during the test, especially if a biopsy is needed. Never hesitate to ask your provider questions prior to it so you know exactly what to expect and your mind can be put at ease.
Treatment
If precancerous cells are found in the colposcopy sample, the provider may recommend a treatment called a LEEP or cone. These are minor surgical procedures where the abnormal cells can be removed from the cervix. There is a high likelihood that the precancerous cells will be completely removed during the procedure, preventing them from developing into a cervical cancer.
If cancerous cells are found, there are treatment options including surgery, chemotherapy, and radiation. The choice of treatment will be determined based on the stage of cancer, the patient’s age, and desire for future pregnancy.
Bottom Line
Prevention is the key to maintaining a healthy cervix. With HPV being the main cause of cervical cancer, it is strongly recommended to get the HPV vaccine. 80% of sexually active people are expected to transmit the virus within their lifetime. HPV vaccines are safe and very effective at reducing rates of cervical cancer and are recommended for all eligible people starting at age 9.
Screening for cervical cancer, through Pap smear tests and HPV tests, is integral in the early detection and treatment of precancerous and cancerous lesions of the cervix. Your Ob-Gyn will be able to make the proper recommendations for screening based on your age, medical history, and other risk factors.