HCA Houston Healthcare - January 25, 2022

Cervical cancer is a type of cancer that occurs in the cells of the cervix, the lowermost part of the uterus. It was once one of the most common causes of cancer death for Americans with cervixes, according to the American Cancer Society (ACS). Thanks to the increased use of the Pap test, cervical cancer death rates have dropped significantly in the past 40 years.

Although cervical cancer death rates have fallen, it's still important to promote cervical health because all people with a cervix are at risk for the disease. In the United States, about 14,480 new cases of invasive cervical cancer were diagnosed in 2021, and about 4,290 individuals died of the disease. Most people who are diagnosed with cervical cancer have not been screened recently, but screening is important for early detection.

What are the symptoms of cervical cancer?

Cervical cancer may not cause any symptoms in the early stages. When the cancer becomes larger and grows into nearby tissue, patients may experience symptoms such as:

  • Abnormal vaginal bleeding, such as bleeding after intercourse, bleeding after menopause, bleeding or spotting between periods or periods that are longer or heavier than usual.
  • Unusual discharge from the vagina, which may include blood.
  • Pain during sex.
  • Pain in the pelvic region.

However, these symptoms can be caused by other health conditions, so it's important to see a doctor as soon as possible to get them checked out.

What are the risk factors?

Certain risk factors for cervical cancer can be changed, while others cannot. Some of these risk factors include:

  • HPV infection — Human papillomavirus (HPV) infection is the most important risk factor for cervical cancer. HPV is a group of over 150 viruses, some of which can cause growths called papillomas (warts). Some of these warts are considered high-risk because they are strongly linked to cancers, including cervical cancer.
  • Sexual history — Becoming sexually active at a young age, having many sexual partners and having a high-risk partner can increase the risk for cervical cancer. Chlamydia infection also increases an individual's risk for cervical cancer.
  • Smoking — Individuals who smoke are about twice as likely to get cervical cancer as those who don't smoke.
  • Immune system deficiency — A weakened immune system can increase the risk of developing cervical cancer. A weakened immune system can be a result of immune suppression from corticosteroids, organ transplant, other cancer treatments or from HIV (human immunodeficiency virus).
  • Family history — Cervical cancer can run in some families. If an immediate family member had cervical cancer, you have a higher risk of developing the disease than you would if no one in your family had it.
  • Race/ethnicity — Black and Hispanic individuals with cervixes develop HPV-associated cervical cancer more than people of other races and ethnicities, according to the Centers for Disease Control and Prevention (CDC).

How to promote cervical health

Lifestyle changes can lower your risk for cervical cancer. For example, if you smoke, you should consider quitting, especially if you have other risk factors. Other ways to promote cervical health include:

  • HPV vaccine — The HPV vaccine protects against the types of HPV that cause 90% of cervical cancers and other diseases. ACS recommends patients of all genders get vaccinated between the ages of 9 and 12 with "catch-up" vaccination for everyone who is not adequately vaccinated through age 26. Adults 27 to 45 may get the vaccine after talking to their doctor if they were not adequately vaccinated when they were younger.
  • Diet — A diet rich in fruits and vegetables can lower your risk of developing cervical cancer. The Mediterranean diet, which includes whole grains, beans, legumes, and low-fat or fat-free dairy products can also reduce the risk of cervical cancer and promote heart health.
  • Exercise — According to the Journal of Lower Genital Tract Disease, individuals who did not get regular physical activity had an increased risk of cervical cancer. Just 30 minutes of aerobic exercise, such as walking, swimming or cycling, significantly reduced a person's risk of getting cervical cancer.
  • Condom use and limiting sexual partners — Since HPV is spread through skin-to-skin contact, using a condom correctly from start to finish during every sexual act can reduce your risk of exposure.

What are the recommendations for cervical cancer screening?

Sarah Cannon, the Cancer Institute of HCA Healthcare, recommends the following:

Population

Test/Procedure

Recommendation

Age 21-29

Pap test

Pap test every three years

Age 30-65

Pap test and HPV test

Pap test and HPV test every five years

Age 65+

Women with normal history should stop testing*

*Women with an abnormal diagnosis should be tested for 20 years following the result, even if testing continues past age 65. A woman whose uterus and cervix have been removed for non-cervical cancer reasons, and who has no history of cervical or pre-cervical cancer, should not be tested.

People with several risk factors may need to be screened more frequently, especially if they have a history of health conditions like herpes, HIV or other sexually transmitted infections.

Cervical cancer is highly preventable and treatable if it's caught in the early stages. Getting screened according to your age group and risk factors can lead to early detection, and focusing on the risk factors you can modify can help lower your risk. Talk to your doctor if you have questions about your risk factors or how often you should be screened.