Making Sense of Cervical Cancer

Cervical Cancer

What is cervical cancer?

• Cervical cancer is cancer that starts in the cervix, which is the lower part of your uterus (womb).  The cervix is where the uterus connects to the vagina.
• Before cancer develops, cells in the cervix change and become abnormal. These abnormal cell changes are called dysplasia (dis-PLAY-zha) or cervical intraepithelial neoplasia (CIN).
• Abnormal cells may be found when they are mild, moderate, or severe. Severely abnormal cells are considered pre-cancerous.
• Many mild and moderately abnormal cells will go away on their own without treatment.
• Removing cells that are pre-cancerous can prevent cervical cancer from developing.
• If left untreated, pre-cancerous cells may progress to cancer cells, but that can take 10 to 15 years.
• Screening tests can find changes in cervical cells before cancer develops and help prevent cervical cancer.
• Sometimes, screening tests find cells that have already progressed to cancer.This is more common in older women who have never been screened or have not been screened in a long time.
• Cervical cancer is most successfully treated if it is found at an early stage.

What causes cervical cancer?

• Human papillomavirus (HPV) is a skin cell virus that causes cervical cancer.
• HPV is not the same as human immunodeficiency virus (HIV, which causes AIDS) or herpes simplex virus (HSV, which may cause cold sores and genital sores).
• Infection with HPV is very common among adults in the United States. In fact, most people will have HPV at some point in their lives.
• Usually, your body’s immune system clears the infection, and HPV goes away on its own in a relatively short time.
• If HPV does not go away and stays in the cells for a long time, pre-cancer and cancer are more likely to develop.

HPV

Is HPV infection serious?

• There are many types of HPV.
• The types that can lead to cervical cancer are called high-risk types.
• Other types, called low-risk types, may cause genital warts but do not cause cervical cancer.
• High-risk HPV is a problem only when it doesn’t go away.  If it stays in your skin cells for a long time, it can lead to cervical cancer.

Are there symptoms of HPV?

• No. Infection with high-risk HPV does not cause symptoms in the cervix; so most people do not know they have it.
• Most people only know they have HPV after being screened for cervical cancer.
• A person can have HPV for a very long time before it’s found.

How does a person get HPV?

• HPV is spread from one person to another by skin-to-skin contact.
• HPV can be spread by vaginal, anal, and oral sex.
• HPV can be spread even if there is no intercourse.
• HPV can be spread even when condoms are used between a man and a woman.
• HPV can be spread in women who have sex with women and in men who have sex with men.

Are there any ways to avoid getting HPV?

Below are four ways to reduce your risk for getting HPV:

• Avoid sexual contact.
• Limit your sexual partners.
• Use condoms or dental dams.  Condoms and dental dams don’t fully protect from HPV, but they can lower the chance you’ll get it.  Condoms also help prevent HIV, herpes, and other sexually transmitted infections.
• Get vaccinated. There are two HPV vaccines, Gardasil and Cervarix. Both are safe and effective in preventing the majority of cervical cancers and abnormal Pap tests. Gardasil can also prevent the majority of genital warts.

Cervical Cancer Screening

What screening tests are done for cervical cancer?

There are two main kinds of screening tests: the Pap test and the HPV test.

What is the Pap test?

The Pap test is used to look for abnormal cervical cells.

• The Pap test is used to look for abnormal cervical cells. Abnormal cervical cells are not visible to your clinician at the time of your exam.
• Pap tests are often done during the pelvic exam portion of a well-woman visit.
• During a Pap test, your health care provider will collect a sample of cervical cells for analysis by a laboratory.
• About 90% of Pap test results are normal.
• If the test result is abnormal, you may need more tests.
• In most cases, an abnormal Pap test result does not mean that a woman has cancer.

What is the HPV test?

• The HPV test looks for high-risk HPV in a woman’s cervix.
• This test can use the same sample of cells taken for the Pap test or a separate sample taken right after the Pap.
• A positive test result means a woman has high-risk HPV. She should be followed closely as long as the HPV test remains positive, since a woman with HPV has a greater risk of developing abnormal cells.
• A positive HPV test result does not necessarily mean that a woman has cancer or will develop cancer.
• Also, a positive HPV test result does not mean that your partner has been unfaithful. A person can have HPV for a long time before it’s found.

When would an HPV test be done?

• The HPV test is used in two ways:
  • To see if a woman with an inconclusive Pap test result (one that shows cells that are not clearly normal, but not clearly abnormal) needs additional tests.  Testing for HPV when there is an inconclusive Pap test result is appropriate for all women who are screened from ages 21 to 65.
  • To improve screening for cervical cancer prevention or detection, along with the Pap test, in women age 30 or older.
• Women ages 21 to 29 should not be screened with an HPV test in addition to the Pap test for routine screening. HPV infection is very common in this age group and usually goes away.  Women 30 or older who have HPV are more likely to have had it a long time. Women who have a long-term HPV infection have a greater risk of developing cervical pre-cancer or cancer.

When should women be screened for cervical cancer?

• Experts recommend that a woman’s first Pap test be done at age 21.
• Women ages 21 to 29 should have a Pap test every three years.
• It is preferred that women ages 30 to 65 have a Pap test plus an HPV test every five years.  Another option for women is to have a Pap test alone every three years.

When can women stop getting screened for cervical cancer?

• Women age 65 or older with a current history of normal screening results and no previous cervical pre-cancer or cancer should not continue cervical cancer screening.
• Women of any age who have had a total hysterectomy (surgery to remove the uterus and cervix) that was not performed to treat cancer or dysplasia don’t need to be screened.

How can I find out more about cervical cancer screening?

For help understanding the results of your screening tests, go here.

Talking with Your Partner About HPV

Finding out you have HPV can be disturbing. It’s important to make sure you have the facts about HPV to discuss with your partner:

• Most adults have HPV at some point in their lives.
• HPV doesn’t cause symptoms and usually goes away on its own.
• Most people with HPV don’t know they have it.
• Usually it is impossible to know which partner gave a person HPV.
• HPV is not a sign that you or your partner was unfaithful.
• It is not helpful or fair to blame your partner if you have HPV.