What Every Woman Should Know About Cervical Cancer and the Human Papilloma Virus

January 26, 2010 - January is National Cervical Cancer Awareness Month.  Emory Eastside Medical Center is using this health awareness event to urge all women who have not had a Pap test in five or more years and those who have never had a Pap test to contact their healthcare provider and schedule a Pap test today.

Nationally, 11,270 women are diagnosed with cervical cancer each year and 4,070 women will die from it.  In Georgia, there are about 340 cases of cervical cancer in 2009.  The American Cancer Society says that cervical cancer deaths in Georgia are rare.

"It is important to know and understand the risk factors associated with cervical cancer," said Sabrina O. Falkner, M.D., an OB/GYN physician with Emory Eastside Medical Center.

Risk factors for cervical cancer include the following:

• Multiple sex partners
• Sex at an early age
• Sex partner that has had multiple sex partners
• HPV (Human Papillomavirus) infection

The American Cancer Society reports that between 60 and 80 percent of American women with newly diagnosed invasive cervical cancer had not had a Pap test in the past five years…and may never have had one. Unscreened groups include women over the age of 50, uninsured or underinsured women, minorities, and low-income women, especially those in rural areas.

While cancer affects people of all racial and ethnic groups, it does not affect all groups equally. Public health officials are particularly concerned about urging African-American women to have regular Pap tests because they have significantly higher incidence and mortality rates of cervical cancer than do white, non-Hispanic women

"Cervical cancer deaths are almost completely preventable.  Pre-cancerous stages are detected during routine Pap tests and are very treatable with modern medical advances.  Young women are also now offered a vaccine that can significantly reduce the chances of contracting the viral infection HPV, which is strongly linked to the development of cervical cancer," said Dr. Falkner.

In June 2006, the Food and Drug Administration approved the use of Gardasil, a new vaccine designed to prevent infection from HPV. The vaccine protects against four types of HPV. Two of these types, 16 and 18, can cause cervical cancer, while the other two types, 6 and 11, can cause genital warts. Altogether, these four types of HPV cause 70 percent of cervical cancers and 90 percent of genital warts. The vaccine is recommended for 11- and 12-year-old girls and can be given from the ages of 9 to 26.

The Georgia Department of Health recommends the following cervical cancer screening activities:

• An annual pelvic exam and regular Pap test for all women starting about three years after first sexual activity, or no later than 21 years of age. This is necessary even if you have received the HPV vaccination.
• Starting at age 30, women who have had three or more normal Pap tests in a row may get screened every two to three years.
• Women over the age of 70, who have had three or more normal Pap tests and no abnormal Pap test result in the last 10 years, may choose to stop having Pap tests.
• Women who have had a total hysterectomy may choose to stop having Pap tests, unless the hysterectomy was treatment for cervical cancer or pre-cancer.
• If you have risk factors, such as diethylstilbestrol (DES) exposure before birth, HIV infection, weakened immune system, or chronic steroid use, continue to have yearly Pap tests.

Pre-cancerous changes of the cervix usually do not cause pain. In fact, they generally do not cause any symptoms and are not detected unless a woman has a pelvic exam and a Pap test. The Pap test, which detects early pre-cancerous cells, has lowered cases of cervical cancer in the United States by 75 percent. These cancers can be effectively treated without re-occurrence if found in its early stage. The likelihood of survival from cervical cancer is almost 100 percent with appropriate treatment and follow-up.