For most women, a Pap smear or HPV test as part of an annual checkup with the OB/GYN is part of the routine. But how much do you know about cervical cancer, the condition the Pap smear helps detect?
The American Cancer Society estimated that 13,800 new cases of cervical cancer would be diagnosed in the United States in 2020. If that seems like a relatively low number, it is—and that’s largely because of advancements in the detection and treatment of the condition over the past few decades.
“Cervical cancer is unique in that it can often be prevented through regular screenings,” says Don Wilson, MD, gynecologist and women’s health specialist with West Tennessee Medical Group GYN Specialists. “Screenings allow us to detect precancerous changes and remove them in many cases, long before they develop into cancer.”
Let’s take a deeper dive into what cervical cancer is and how you can prevent it.
Defining Cervical Cancer
Cervical cancer is a type of cancer that develops in the cervix, which is the lower part of the uterus. This type of cancer is most often caused by the human papillomavirus, commonly referenced as HPV.
HPV is spread through sexual contact, and it is incredibly common. As many as 80 percent of women will develop HPV at some point before turning 50, often without knowing it. This number may decrease as HPV vaccination becomes more widespread.
In most cases, the body’s immune system is able to fend off the human papillomavirus. But in some cases, HPV may lead to cervical lesions that become cancerous over time.
“In most cases, HPV, precancerous cervical changes, and cervical cancer are all what we call ‘silent,’ meaning they don’t cause noticeable symptoms until later stages,” says Jeff Ball, MD, gynecologist and women’s health specialist with West Tennessee Medical Group GYN Specialists. “That’s why having regular screenings as advised by your doctor is so important.”
Who’s at Risk for Cervical Cancer
We mentioned above that cervical cancer typically is caused by HPV. That means that nearly every unvaccinated woman is at risk of developing the condition.
But certain risk factors may place you at a higher risk of developing the condition as the result of an HPV infection:
- Using oral contraceptives for five or more years
- Having three or more children
- Having several sexual partners
- Having HIV or another immunosuppressive medical condition
Screening for Cervical Cancer
Because HPV is usually slow to develop into cancer, precancerous lesions can often be spotted and removed during screenings. But when should you begin these screenings—and how often do you need them?
The guidance for cervical cancer screening has changed some in the past few years. The American Cancer Society now recommends that cervical cancer screening for most women begin at age 25. Between ages 25 and 65, screening should consist of a standalone HPV test every five years, co-testing using both an HPV test and a Pap smear every five years, or a Pap smear alone every three years.
What’s important to note, though, is that decisions related to when you are screened and the type of screening you receive are best made between you and your OB/GYN. He or she can recommend a screening frequency and type based on your individual needs, including your personal and family medical history and lifestyle habits.
During either an HPV test or a Pap smear, a small sampling of cells are removed from your cervix and screened for abnormalities and/or the presence of HPV.
If anything abnormal is present, your provider can help you determine next steps.
What Happens After Cervical Cancer Screening?
If a Pap smear or HPV test shows abnormalities, a colposcopy is often the next step.
During this procedure, your doctor will closely examine your cervix using a tool called a “colposcope.” In most cases, the doctor will also remove cervical tissue to biopsy it for cervical cancer.
If no cancerous or precancerous lesions are detected, your OB/GYN may recommend retesting after a period of time to determine if the cervical changes have disappeared on their own. They often do.
But in other cases, your provider may recommend removing these cervical changes to reduce the risk of them developing into cancer. This can be performed in a number of different ways, including cone biopsy (which cuts out the abnormal cells), cryotherapy (which freezes abnormal cells), and LEEP (which uses electrical current to remove abnormal cells).
Each of these procedures can be performed in a physician’s office, typically using local anesthesia.
West Tennessee Medical Group GYN Specialists specializes in providing gynecological care. To schedule an appointment with Jeff Ball, MD, Don Wilson, MD, or Amy White, NP, call (731) 660-3344.