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Early Detection and Prevention of Cervical Cancer

Scot Ackerman , M.D.

January 27, 2020

Ackerman Cancer Center wants to promote health and wellness to all its patients and their families. It is important to be aware and conscious of your health and to take the necessary precautions for disease prevention, if possible. Being proactive in your well-being can lead to a long and healthy life.

During the month of January, we bring awareness to cervical cancer. Unfortunately, all women are at risk for developing cervical cancer. However, there are factors that can increase a women’s risk. Even with these risk factors, some women will never develop cervical cancer.

  • Human papillomavirus (HPV) infection
  • immune system deficiency
  • chlamydia infection
  • diet low in fruits and vegetables
  • being overweight
  • long-term use of oral contraceptives
  • IUD use
  • having multiple, full-term pregnancies
  • being younger than 17 in your first pregnancy
  • diethylstilbestrol (DES)
  • a family history of cervical cancer

Cervical cancer once was the leading cause of cancer death in women in the United States. Since the introduction of the Pap smear test in the 1940s, the incidence of cervical cancer has dramatically declined by more than 50% in the last 30 years, in part due to the increased use of cervical cancer screening – the Pap smear test. According to the American Cancer Society estimates for 2020, approximately 13,800 new cases of cervical cancer will be diagnosed and about 4,300 women will die from cervical cancer in the United States. However, with advances in vaccinations and technology, cervical cancer is treatable and preventable.

Screening
The Pap smear test is still the most used and widespread screening tool for cervical cancer. It is recommended that women, ages 21-65 be screened every 3 years (if a negative result) during their annual physical exam. The Pap smear test is able to detect cellular abnormalities and precancerous lesions with tissue samples from the cervix. In addition to the Pap smear test, it is also recommended an HPV test (co-testing) be conducted to detect the presence of the Human papillomavirus, which can cause cervical cancer. It is important for women to have these tests conducted in safeguarding against HPV and cervical cancer.

Vaccinations
Currently, the only vaccine to protect against HPV in the United States is Gardasil 9. Cervarix was discontinued in the United States back in 2016 because it was unable to compete with Gardasil 9. Each of the vaccines protect against HPV 16 and 18, which are two of the high-risk strains of HPV known to cause cervical cancer. An added benefit for the use of Gardasil 9 is the ability to protect against other strains of cancer-causing HPV types. The FDA approved Gardasil 9 for use in females ages 9-26 for the prevention against, cervical, vaginal, vulvar, and anal cancer and genital warts. For males ages 9-26, it protects against genital warts and anal cancer. An update to the Gardasil 9 vaccine occurred in October 2018. The FDA has now approved Gardasil 9 to be used by women and men between the ages of 27-45.

Treatment
The treatment modalities for cervical cancer depend on different factors including, the stage of the cancer, other health problems of the patient, and patient preference of treatment. Treatment options include immunotherapy, targeted therapy, chemotherapy, radiation, and surgery. Normally, patients use a mix of these treatment options. The most common form of treatment is surgery, in the form of a hysterectomy (complete removal of a woman’s uterus).

The treatment for cervical cancer has improved and is seen through the survival rate of women. According to Cancer.net, the 5-year survival rate is 67%. Survival rates also depend on the stage of the cancer and when it was diagnosed. When detected early, the 5-year survival rate is 92%. If cervical cancer has spread to surrounding tissues and organs, the 5-year survival rate lowers to 57%. And, if cervical cancer spreads to non-surrounding tissues and organs, the 5-year survival rate is only 17%. Looking at how these survival rates change shows the importance of the Pap smear test in being able to detect abnormalities in the cervix.

Through screening, vaccinations, and treatment, cervical cancer is a preventable disease. Pap smears play an important role in the early detection and prevention of cervical cancer. Encourage the women in your life to be screened annually or every three years. Stay proactive in your health and wellness and you will see the results.

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