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January is Cervical Health Awareness Month - a time when an often quiet subject is brought into light. Nearly 13,000 women in the United States are diagnosed with cervical cancer each year, and approximately 4,000 die as a result. What many people don't know is that this disease is easily preventable with vaccination and appropriate screening.
In both the United States and abroad, the lack of comfort with talking about these topics results in women avoiding routine gynecologic care due to a sense of shame and embarrassment. Both patients and doctors need to feel comfortable discussing sexual health, including cervical cancer prevention, but many times those conversations are often rushed through or avoided altogether.
There is no single or simple solution to curing cervical cancer, but it does involve more than just having quality health care. When it comes to sexual and reproductive health, we need to be as comfortable as possible, and have the confidence to seek the care and support that women need.
Luckily, cervical cancer is preventable by taking Pap and HPV tests, and the cervical cancer vaccines.
The most common cause is the human papillomavirus, or HPV. Roughly 99% of cervical cancers are caused by this sexually transmitted infection. The most common strains of the virus, HPV 16 and HPV 18, are responsible for approximately 70% of all cases of the disease. Approximately, 14 million new HPV infections are detected each year, and although some do clear up, infections that persist can lead to serious health problems.
The HPV vaccines can help prevent infection from both high risk HPV types that can lead to cervical cancer, and low risk types that cause genital warts. It must be given in three doses, and can protect against four HPV types - the two most common high risk strains: HPV 16 and 18, and the two most common low risk types, HPV 6 and 11. Ideally, the vaccine should be given before one becomes sexually active.
The U.S. Food and Drug Administration approved 3 HPV vaccines. The first was Gardasil, which was approved in 2006 to protect against HPV 16 and HPV 18. In 2009, the FDA approved Ceravix, and a third vaccine, Gardasil 9, was approved in 2014. Gardasil 9 has shown to be 97% effective in preventing cervical, vulvar and vaginal cancer, and protecting against additional types of high risk HPV strains.
The CDC recommends that all boys and girls get the HPV vaccine at age 11 or 12, as the vaccine produces a stronger immune response when taken during the preteen years. For this reason, up until age 14, only 2 doses of the vaccine are required. For those 15 and older, a full 3 dose series is needed. The vaccine is available for all males and females through age 45.
According to the National Institutes of Health, cervical cancer develops slowly, starting as a precancerous condition called dysplasia. These abnormal cells are easily detected through a Pap test and can be treated effectively. There is also an HPV test that, when combined with a Pap test in women over 30 years of age, can help identify women at risk for developing cervical cancer.
If left undetected, dysplasia can turn into cervical cancer, which can potentially spread to the bladder, intestines, lungs, and liver. Many women may not suspect cervical cancer until it has become advanced or metastasizes, which stresses the importance of annual Pap tests even more.
All women 21 and older should receive regular exams and screenings. This should include an annual pelvic exam and a periodic Pap test. For a Pap test, cells are collected from the cervix so that they can be examined for any abnormalities. Women 21 to 29 years of age should receive a Pap test every 3 years, as long as their results remain normal. Women 30 to 65 years old should receive a Pap test combined with an HPV test every 5 years, as long as their results remain normal. Alternatively, women 30 and over may opt for just a Pap test every 3 years.
Symptoms of cervical cancer may not show up until the cancer is advanced. The symptoms usually include:
It's important to keep in mind that the warning signs of cervical cancer may be scarce. Often, the disease doesn't cause pain or other obvious warning signs until the later stages. Women who suspect a problem should not ignore their symptoms and seek a medical evaluation.
What you can do
Cervical cancer is preventable and treatable. With the right education, comfortability, and preventative actions, your chances of developing cervical cancer are relatively low.
Talk to the women in your life about getting properly screened and tested. Remind them how important annual testing is, and encourage them to speak with their doctor about the HPV vaccination. You can make a difference by speaking out, making cervical health a normal topic, and helping educate the women and men in your life.
PLEASE CONSULT WITH YOUR DOCTOR OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL BEFORE TAKING ANY MEDICATION, SUPPLEMENTS, OR BEGINNING ANY HEALTH REGIMEN.