January is Cervical Cancer Awareness Month

By Gigi Chen, MD

As with any cancer, prevention and early detection is crucial. With increasing use of the PAP test (a screening looking for any changes to the cervix) the number of cervical cancer cases has decreased in American women by 70%. From 1992 to 2003 the number of deaths from cervical cancer in American women was on a steady decline, and has since plateaued. Cervical cancer tends to occur during a woman’s mid-life with most cases occurring before the age of 50 and more than 20% of cervical cancer cases occurring in women over the age of 65.

Though screenings are being performed to help prevent cervical cancer there are risk factors that aid in the development of the disease. HPV is the primary cause of the disease. Certain types of HPV are called high-risk types because they are strongly linked to cancers, including cancer of the cervix, vulva, and vagina in women, penile cancer in men, and anal and oral cancer in both men and women. Infection with HPV is common, and in most people the body is able to clear the infection on its own. Sometimes, however, the infection does not go away and becomes chronic. Chronic infection can lead to the development of cervical cancer. Though HPV can be spread during sex, sex doesn't have to occur for the infection to spread. All that is needed to pass HPV from one person to another is skin-to-skin contact with an area of the body infected with HPV. There is currently no cure for HPV infection, however, there are ways to treat the warts and abnormal cell growth that HPV causes.

Another risk factor for cervical cancer is smoking. Women who smoke are almost twice and likely to develop cervical cancer than those women who do not smoke. Also, women who are HIV+ or have AIDS are also more likely to develop the disease due to their damaged immune system and therefore have a higher chance of contracting HPV. Other risk factors include family history, and taking oral contraceptives for an extended period of time, early onset of sexual activity and multiple sexual partners.

In order to prevent the disease here are some basic recommendations:

• Get vaccinated against HPV
• All women should begin cervical cancer testing (screening) at age 21. Women aged 21 to 29, should have a Pap test every 3 years. HPV testing should not be used for screening in this age group (although it may be used as a part of follow-up for an abnormal Pap test).
• Beginning at age 30, the preferred way to screen is with a Pap test combined with an HPV test every 5 years. This should continue until age 65.
• Another reasonable option for women 30 to 65 is to get tested every 3 years with just the Pap test.

Please remember, these are basic guidelines for helping to prevent cervical cancer. Always consult your physician for more detailed information.

Dr. Chen is board certified in medical oncology and hematology and practices with Diablo Valley Oncology, located at the California Cancer and Research Institute in Pleasant Hill. She treats all forms of cancer and blood disorders and has a special interest in lung and gynecologic cancer.