January is also Cervical Health Awareness Month. Every year, more than 12,000 Americans are diagnosed with cervical cancer. Cervical cancer was once considered the leading cause of death among women in the United States, but today is considered highly preventable and treatable due to vaccination and early detection from routine testing.
Mona Orady, MD, gynecological surgeon with Dignity Health Medical Group — Saint Francis/St. Mary’s; Ann Powelson, MD, OB-GYN with Dignity Health Mercy Medical Group and My-Le To, DO, OB-GYN with Dignity Health Woodland Clinic share important reminders on preventing and reducing the risk of developing cervical cancer.
Know the Signs
Cervical cancer is typically undetectable to the patient until it is at an advanced stage, but occasionally symptoms can be detected at home. Be sure to bring up any of the following symptoms at your doctor’s visit. Potential signs of cervical cancer include:
- Abnormal spotting or bleeding during or after intercourse
- Abnormal discharge
- Pelvic pain
- Pain during urination.
“With cervical cancer symptoms often unnoticeable or easily confused with other gynecological issues, routine testing for people with a cervix can save lives,” says Dr. Powelson.
The CDC recommends cervical cancer screenings and HPV testing as the best way to detect cervical cancer and abnormalities. Human papillomavirus (HPV), is a sexually transmitted virus that can be carried by both men and women and is the primary cause of cervical cancer.
The most common and widely recognized form of cervical screenings are Pap tests, also known as Pap smears. These tests look for precancerous cell changes on the cervix that could evolve into cancer if not treated in a timely manner.
Dr. Powelson recommends starting screenings at age 21 regardless of sexual activity. There are, however, some different recommendations for immunocompromised patients, so it’s important to discuss with your doctor what timing is right for you. A Pap smear is recommended for most women every 3-5 years. Abnormal results may prompt more frequent testing, such as once a year or every 6 months.
Abnormal Pap smear results are common and are rarely a cause for concern. “Many women will have abnormal Pap smear results in their lifetime, and many will test positive for HPV.” says Dr. Powelson.
When it comes to HPV testing, Dr. To recommends getting screened starting at 30 years old along with your Pap smear. HPV testing is usually only performed on people under 30 if they have abnormal Pap smear results as a reflex test. (For additional information on HPV prevention, visit cdc.gov/hpv).
In addition to routine screenings and Pap smears, vaccination against HPV is a key preventive measure against cervical cancer. “The HPV vaccine protects against the four most common HPV strains known to cause cervical cancer,” says Dr. Orady. This vaccine is recommended for people regardless of their sexual activity.
Most patients are encouraged to receive the HPV vaccine between the ages of 9 and 26. “Older individuals can also receive inoculation, but the sooner that patients receive it, the better,” says Dr. To.
For parents who may be hesitant about getting their child vaccinated, It’s important to note that the HPV vaccine allows children to develop immunity from harmful strains of HPV even if they are not sexually active. In fact, getting the HPV vaccine before becoming sexually active offers the highest level of protection from HPV. Dr. To also emphasizes that the HPV shot is the only FDA approved vaccine that can help prevent cancer. The vaccine requires two doses for those ages 9 to 14 and three doses for those ages 15 to 26. Even if a patient has had a positive HPV test, they can still benefit from receiving the vaccine.
Everyday Lifestyle Choices
Regular screenings and getting vaccinated against HPV are the most effective ways to help prevent cancer and maintain top cervical health, however, lifestyle choices can also help lower the chances of developing cervical cancer.
Dr. Powelson recommends limiting tobacco use, including vaping, as it can increase the risk for developing cervical cancer.
Dr. To also points to the importance of regular exercise, decreasing stress, maintaining a healthy immune system and practicing monogamy. For those who are sexually active outside of a monogamous relationship, Dr. To strongly recommends using condoms during sexual activity to reduce the risk of sexually transmitted infections.
Making Reproductive Health a Priority
When it comes to cervical health, cancer is just one of many conditions that can affect women. Dr. Orady notes that sexually transmitted infections such as gonorrhea and chlamydia are common causes of cervicitis, an irritation or infection of the cervix, and need to be discussed during wellness exams and screened for in sexually active women.
Dr. Orady says to watch for signs of a cervical infection, inflammation, polyp or dysplasia. These can include abnormal bleeding or pain during or after intercourse, or persistent and unusual vaginal discharge. Other gynecological conditions that women should consider mentioning to their physicians during annual wellness exams include, but are not limited to, urinary issues, prolapse and vaginal dryness.
Dr. To recommends that patients disclose any history of sexual abuse with their gynecologists prior to a wellness exams. Gynecologists like Dr. Orady, Dr. Powelson and Dr. To are uniquely positioned and trained to offer support to patients through medical treatment and referral to mental health specialists.
Don't delay annual wellness exams. Cervical cancer takes years to develop and routine screenings often catch abnormalities early. Despite having little to no symptoms, cervical cancer is considered highly preventable with routine screenings, vaccinations and healthy lifestyle choices.
Other cervical conditions such as sexually transmitted infections are important to monitor for and discuss with your gynecologist during routine wellness exams.
If you or a loved one believe you’re at risk for developing cervical cancer, reach out to your primary care doctor to discuss preventative measures or schedule a screening. For additional information on HPV or the HPV vaccine, reach out to primary care physician or your child’s pediatrician to learn more.