Frances A. Martinez-Diaz, MD, FACOG
Department of Obstetrics and Gynecology
Cooper University Health Care
January is Cervical Health Awareness Month, which is focused on raising awareness about how women can protect themselves from human papillomavirus (HPV) and cervical cancer. HPV is a very common infection that spreads through sexual activity, and it causes almost all cases of cervical cancer. According to national cancer statistics, in 2015 nearly 13,000 new cases of cervical cancer were reported and more than 4,000 women died of the disease in the United States alone. These numbers mirror the American Cancer Society’s estimates for 2018.
The best strategy for identifying cervical cancer is through cervical screening. A lot of changes have occurred within the last decade in terms of screening recommendations, frequency of the tests, and the types of tests used.
Knowing the association of HPV with abnormal cellular changes in the cervix led doctors to change the way they screen for cervical cancer. HPV is the most common sexually transmitted infection in the United States and is spread from skin-to-skin contact. Usually it is a transient infection that typically will clear within 24 months. Persistent HPV infection increases the risk of developing abnormal (dysplastic or precancerous) cells that can lead to cervical cancer.
Cervical screening through a Pap test allows for early identification of changes in the cells and treatment of them before they can turn into cancer.
As a general guideline, screening should start at 21 years of age, even if sexual activity has not started. For most of the population, screening will stop at age 65. Most women who have had their uterus surgically removed will not need to continue screening. A woman’s age will determine if HPV testing is needed as part of the screening process and how frequently it should be done (three years versus five years). Surveillance screening is done at a different frequency than management surveillance of women who have abnormalities. Women who are HIV positive should have lifelong screening.
As with any disease, the best course of action against HPV and cervical cancer is prevention. Females and males from ages 9 to 26 should receive a series of HPV vaccinations, ideally beginning before 12 years of age. If given between ages 9 and 14, only two shots are needed; otherwise, three doses should be administered. In October 2018 the U.S. Food and Drug Administration approved the use of HPV vaccine in women and men between the ages of 27 and 45.
Women who have been vaccinated should continue to get Pap tests for cervical cancer screening as recommended by a physician. Other prevention tips include not smoking, always using a condom during sexual activity, and limiting the number of sexual partners.
Talk to your medical provider to determine the most adequate strategy for you. Remember, prevention and early detection are your best tools against cervical cancer.