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Mammograms help women keep ahead of breast cancer. How can women monitor their cervical health?

Having regular Pap smears is the best way to monitor cervical health. Screening should begin at age 21 or within three years of becoming sexually active. For women under 30, the American College of Obstetricians and Gynecologists recommend annual screening. For women aged 30 and over, the screening interval may be increased based on the woman's screening history. For women with a history of three consecutive normal Pap smears within a five-year period, the interval may be increased to every three years. The addition of an HPV test to Pap smears can also be considered for women aged 30 and over. If both tests are negative (that is, the Pap smear is normal and the HPV test is negative), the screening interval may then be increased to three years. 

What can go wrong in the cervical area?

There are a number of infections that can affect the cervix, including: 

Some infections cause symptoms, for example, trichomonas can cause a discharge. Others, such as HPV, do not. We do not recommend routinely screening young women for HPV because the infection is common at that age. Some HPV infections result in genital warts and some lead to abnormal Pap smears, usually low-grade changes.

We do suggest screening for more serious abnormalities with Pap smears, however, because some women develop high-grade or potentially precancerous lesions and cervical cancer.

Mammograms help women keep ahead of breast cancer. How can women monitor their cervical health?

Having regular Pap smears is the best way to monitor cervical health. Screening should begin at age 21 or within three years of becoming sexually active. We suggest the following guidelines for Pap smears:

  • Women age 21 to 29 years - every three years.
  • Women age 30 to 65 years - every five years with an HPV test.
  • Women age 65 and older – no testing unless there is a history of moderate or severe cervical dysplasia or cervical cancer and they have had three negative Pap tests in a row.

What happens if I have an abnormal screening test result?

After an abnormal Pap screening result, you may need additional testing, which can be as routine as a repeat Pap or an HPV test. It could also be as detailed as a colposcopy exam. If the follow-up tests show precancerous changes, you may need to have the abnormal cells removed.

Know that cervical cancer screening results may not always be accurate, just like any other lab test. Many factors can cause false results, including:

  • Too few cells in the sample.
  • Too few abnormal cells to study.
  • An infection or blood that hides abnormal cells.
  • Douching or vaginal medications that wash away or dilute abnormal cells.

To avoid false negatives, do not douche, have sex or use vaginal medications or hygiene products for two days before the test. Do not have a screening if you have your menstrual period.

How many American women are diagnosed with cervical cancer each year? How does that number change worldwide?

In the U.S., the Centers for Disease Control estimates that approximately 12,109 women were diagnosed with cervical cancer in 2011. Of that number, roughly 4,092 died of cervical cancer. Worldwide, cervical cancer is the second leading cause of cancer-related deaths in women, and in some parts of the world, it is the leading cause of such deaths. Of the 500,000 women diagnosed each year with cervical cancer worldwide, approximately half will die. Most women diagnosed with cervical cancer come from developing nations.

Are there known causes of cervical cancer?

It has been proven that oncogenic (cancer-causing) HPV infection is needed for cervical cancer to develop. That said, many women have oncogenic HPV infections, and the majority do not get cervical cancer. This shows us that other factors clearly play a role. One such factor would be immunosuppression, which means the body becomes incapable of controlling HPV infection.

Can anything be done to prevent those causes?

Yes. Two HPV vaccines are available to protect males and females against the types of HPV that cause most cervical, vaginal, and vulvar cancers. These are given in three doses and are recommended for girls age 11 and 12. Females age 13 through 26 who did not get any or all of the shots when they were younger should make an appointment to get the vaccine. Doctors recommend that females get the same vaccine brand for all three doses when possible. Even after having the HPV vaccine, women should still have regular Pap tests to screen for cervical cancer.

Other ways to reduce your chance of contracting cervical cancer include:

  • Quitting smoking.
  • Using condoms during sex.
  • Limiting your number of sexual partners.

How effective is the HPV vaccine?

Clinical trials show the vaccines provide close to 100 percent protection against precancers. Since the vaccine was first recommended in 2006, there has been a 56-percent reduction in HPV infections among teen girls in the US.

Who is giving the vaccine?

Pediatricians, family practitioners, internists, and gynecologists can give the vaccine.

Are there any side effects to the vaccine?

The most common side effects are:
  • Pain at the injection site.
  • Swelling and redness at the injection site.
  • Low-grade fevers.
  • Headache after the injection.

The vaccine does not contain live virus and, as such, is not infectious nor can it cause cancer.