Cervical Cancer

Prevention

Almost all cervical cancers can be prevented by having regular Pap tests. (Pap is short for Papanicolaou, the name of the doctor who devised the test.) The Pap test can detect HPV infection and precancers. Treatment of these problems can stop cervical cancer before it develops or spreads. An HPV test may be performed at the same time as the Pap test. However, it is not recommended as part of regular Pap testing for women under the age of 30. If the Pap test results are questionable, an HPV test will be performed to determine if a strain of the HPV virus that may lead to cervical cancer is present. Also, the new HPV vaccine may be able to prevent cervical cancer.

Another way to prevent cervical cancer is to avoid the following risk factors. Women can:

• Delay having sex until they are older.
• Limit the number of sex partners.
• Avoid sexual intercourse with people who have had many partners.
• Avoid sexual intercourse with people who are infected with HPV, genital warts, or other symptoms of a sexually transmitted disease.
• Have safe sex. The evidence is mixed on whether condoms protect against HPV, but they definitely do protect against HIV and other sexually transmitted diseases.
• Quit smoking.

This section has more information on:

HPV vaccine

Pap test

Improving Prevention & Detection

HPV Vaccine

HPV vaccines have the potential for preventing cervical cancer. A new vaccine called Gardasil offers protection from the virus that causes most cervical cancers by blocking the infection. The drug was approved by the Food and Drug Administration (FDA) in June 2006.

Routine vaccination is recommended for girls and women ages 11 to 26 if they have not already received the vaccine. Giving the vaccine in the 11-to-12 age range activates the girls' immune systems before they are sexually active--which means before they come into contact with HPV.

Higher antibody (protein) levels also are needed to help produce a response to the vaccine that will help protect girls against the virus. It is most effective if given before girls become sexually active. Three doses of the vaccine are given by injection during a six-month period. You receive the first dose followed two months later by the second dose. Six months after you receive the first dose, you receive the third dose.

The most common side effect associated with the vaccine is soreness at the injection site (upper arm), and mild fever or flulike symptoms also have been reported.

Pap test

A Pap test, often called a Pap smear, is a screening procedure used to detect abnormal cells in and around the cervix. In this test, the doctor uses a stick or brush to take a few cells from the cervix while holding the vagina open with a speculum. The cells are sent to a laboratory, where they are examined for signs of abnormality. Results usually take a few weeks and may indicate that the cells are normal or abnormal. An abnormal result could mean inflammation of the cervix, trichomonas or yeast infection, or other causes. In postmenopausal women, the Pap test could detect abnormal glandular cells that could indicate endometrial cancer.

Women should have a Pap test beginning three years after starting vaginal intercourse and no later than age 21.

• At age 30, women with three or more consecutive exams with normal results may have a Pap smear performed less frequently. This is dependent on risk factors and should be discussed with the doctor.
• Women who have been treated for cervical dysplasia (a precancerous lesion) or cancer may need to have a Pap smear more frequently if recommended by the doctor.
• If you have had a hysterectomy, ask your doctor about screening. If you are healthy, had the hysterectomy for a reason other than precancer or cancer, and have normal Pap tests, then you may be screened less frequently than annually. But even if your cervix was removed during your hysterectomy, regular pelvic exams are still recommended to check for precancerous cells in the vaginal and vulva area, especially for those who have been exposed to HPV.

Improving Prevention & Detection

Research to improve detection and screening methods for cervical cancer is ongoing. Some of these advancements may still be in the investigational stage and not yet approved or available.

Because cervical cancer is highly treatable when detected in an early stage, many studies are looking at developing better ways to detect cervical cancer, such as fluorescent spectroscopy. This method uses fluorescent light to detect changes in precancerous cells in the cervix.

A newer Pap test method known as the Thin Prep test transfers a thin layer of cells onto a slide. Because this sample can be preserved, a test for HPV can be done at the same time. (A regular pap smear tests for the presence of abnormal cells, not the virus.)