Category: Women's Health
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Health Risk: Cervical Cancer
July 10, 2009
What is cervical cancer?
Most cervical cancers begin in the cells around the cervix. The Pap test looks for changes in the cervical cells. Sometimes changes can occur in less than a year, but they usually take several years.
When you have a regular Pap test, any changes in the cervix can be identified early - before cancer can start. A Pap is usually done along with a pelvic exam. The pelvic exam is important in finding problems like sexually transmitted diseases or other cancers. But the pelvic exam alone can't find cervical cancer.
Who is at risk?
According to the American Cancer Society (ACS), scientists have made a lot of progress toward understanding what happens in cells of the cervix when cancer develops. Scientists also have found several things that increase the odds that a woman might develop cervical cancer.
Some of the things that put a woman at risk include:
- Human papilloma virus (HPV) infection
- Immunosuppression (such as HIV)
- Diet low in fruits or vegetables or being overweight
- Chlamydia infection
- Long term use of birth-control pills
- Multiple full-term pregnancies - three or more - or first full-term pregnancy when younger than 17 years of age
- Diethylstilbestrol (DES) maternal history
- Family history of cervical cancer
You can also find out more of the risks on the ACS Website.
What is HPV?
HPV is one of the most important risk factors for cervical cancer. It is a group of viruses that can infect cells on the surface of the skin, genitals, anus, mouth and throat. Certain types of HPV may only cause warts on different parts of the body, including genital warts. Other HPV types are considered high-risk types - HPV 16, HPV 18, HPV 31, HPV 33, and HPV 45, as well as some others - because they often cause cancer of the cervix.
According to the ACS, genital HPV is a very common virus usually contracted during vaginal, anal, or oral sex. Though not as common, you can also catch it through skin-to-skin contact with an area of the body infected with HPV. About one-half to three-fourths of the people who have ever had sex will have HPV at some time in their life. HPV usually has no symptoms, unless it is a type that causes genital warts.
Although many women become infected with HPV, not all will develop cervical cancer. It is thought that HPV causes the production of proteins in the body, which turn off the genes responsible for suppressing cell growth. This would allow cells like those in the cervical lining to grow uncontrollably, leading to cancer. The body's immune system may fight the virus and the infection may go away without treatment. However, for others, the infection can persist, leading to cervical cancer.
The HPV Vaccine
Good news. Out of more than 100 HPV types, two types (6 and 11) are responsible for 90% of genital wart cases, and two types (16 and 18) are responsible for 70-75 % of cervical cancers The Gardasil vaccine protects against all four types, and Cervarix protects against 16 and 18
The ACS presently recommends girls between the ages of 11 and 12 and females between 13 and 18 years of age who have not yet received or completed the vaccine series be vaccinated.
These vaccines will prevent HPV only if given before a girl has been exposed to the HPV type. The vaccines are recommended for girls ages 11 to 12 because most girls at this age have not become sexually active. This is also an age when girls will be seeing their doctor and getting other vaccinations. All Humana plans provide complete coverage for the HPV vaccine series. For more information, look at your individual Certificate of Coverage.
- It is important to receive all three doses of the vaccine.
- For best protection, all three doses should be given during a six-month period: the second dose two months after the first and the third at six months.
- Routine Pap tests are still recommended because the HPV vaccine doesn't protect everyone or all HPV types that can cause cervical cancer
How often should I get a Pap test?
Recommendations may differ slightly among national agencies and organizations, such as the American College of Obstetricians and Gynecologists (ACOG), American Cancer Society (ACS) and United States Preventive Services Task Force (USPSTF). To make the best decision, discuss your risks with your doctor and decide which Pap testing schedule is best for you. Also be sure to read your Certificate of Coverage for benefit information for you and your family.
Here are some important things to know from the USPSTF about routine screenings for cervical cancer:
- Who should be tested - Screening for cervical cancer is recommended for both HPV-vaccinated and unvaccinated women
- When to start testing - Screening for cervical cancer should begin approximately three years after first intercourse, but no later than 21 years of age. For women at average risk, a Pap smear screening should be done at least every three years. Women who have had a total hysterectomy for benign disease no longer need to have a Pap. Even though a Pap test may not be done annually, your doctor may still recommend an annual gynecological exam.
What happens during a screening?
To do a Pap test, the doctor removes cells from the cervix by gently scraping or brushing it with a special instrument. The cells are then examined under a microscope in a lab. The Pap is a screening not diagnostic test. If abnormal findings are detected, further testing and treatment will depend on the type of cervical cell findings as well as other factors such as age or risk factors (smoker, exposure to DES, immunosuppression, etc).
Talk to your doctor today to discuss your risks and which Pap testing schedule is best for you. Refer to your certificate of coverage for individual benefit information.
Can cervical cancer be prevented?
While there isn't a guaranteed way to prevent cervical cancer, you can lower your risk by:
- Avoiding risky behaviors - sex at an early age, multiple partners, or sex with someone with multiple partners and sex with uncircumcised males - can increase your risk for HPV infection.
- Using condoms
- Not smoking
- Getting the HPV vaccine
Want to know more about cervical cancer?
Find out more about this topic as well as other topics important to women by visiting the Women's Health Center on MyHumana.
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