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Cervical Health Awareness Month

Cervical Health Awareness Month: Safeguarding Against Cervical Cancer

More than 14,000 U.S. women are diagnosed with invasive cervical cancer, with 4,000 losing their battle with this silent disease annually. While important gains have been made in preventing cervical cancer through screening guidelines and advancements like HPV vaccination, a recent study reported startling statistics noting latter stage cervical cancer is rising in U.S. women.

Researchers at the University of California Los Angeles (UCLA) Department of Obstetrics and Gynecology investigated stage 4 cervical cancer trends in the country by analyzing data from 2001 to 2018. The study, published in the International Journal of Gynecologic Cancer, found a 1.3% increase per year in the disease’s advanced stages, with greatest increase among white women in the South ages 40 to 44 years, among whom cases increased 4.5% annually.

Additionally, researchers participating in this study determined Black women have an overall higher rate of late-stage cervical cancer. Black women in the U.S. also have the highest rate of cervical cancer related deaths according to the American Cancer Society (ACS.)

The 2022 UCLA study further iterates that compared with Black women, White women have lower rates of guideline screenings and HPV vaccinations, with those ages 13 to 17 years having lowest screening rates overall.

According to current ACS statistics, Hispanic women in the U.S. have the highest rates of developing cervical cancer.

The UCLA study was initiated after alarming findings from a noteworthy 2021 study highlighted a 3.39% annual increase in advanced cervical cancer cases among U.S. women ages 30 to 34 years.

Researchers hypothesize younger American women aren’t getting preventative cervical cancer screenings as recommended, especially if no symptoms justify medical treatment.

Importantly, the 2022 UCLA study analyzed accrued data 2 years prior to the worldwide COVID-19 pandemic in 2020, a time when routine healthcare was paused for millions worldwide, translating into potentially even greater increases in advanced cervical cancer cases occurring in U.S. women.

January is designated Cervical Health Awareness Month, offering women timely opportunity to prioritize and safeguard their cervical health. Your local Capital Women’s Care team of women’s health professionals offers vital information about cervical cancer, including symptoms, risk factors, prevention, recommended screening guidelines, plus diagnosis and treatments, along with latest research findings to help you enjoy a long, quality life.

What Causes Cervical Cancer?

All women face cervical cancer risk, which has highest occurrence in women over 30 years of age. Long-lasting infection with certain types of human papillomavirus (HPV) is the main cause of cervical cancer. HPV is a common virus that spreads during sexual intercourse. At least 50% of sexually active people have HPV at some point during their lives without having noticeable symptoms or requiring medical treatment.

For most women, HPV disappears on its own accord; however, if it doesn’t, there’s a strong chance it may cause cervical cancer over time.

Therefore, it’s important to follow recommended HPV vaccination and screening guidelines from your local Capital Women’s Care practitioner to reduce your personal cervical cancer risk.

Cervical Cancer Prevention

Cervical cancer is one of the most preventable cancers today. More than 50% of U.S. women who are diagnosed with cervical cancer have never had or rarely had a pap test.

The most important protection against cervical cancer is to get vaccinated early against HPV (ideally before any risk of HPV exposure takes place) and have regular screenings as recommended by your local Capital Women’s Care practitioner.

The HPV vaccine protects against the types of HPV that most often cause cervical, vaginal and vulvar cancers.

The Centers for Disease Control (CDC) recommends:

  • HPV vaccination for preteens (girls and boys) aged 11 to 12 years but may be administered starting at age 9 years.
  • HPV vaccine also is recommended for everyone through age 26 years if not already vaccinated.
  • HPV vaccination isn’t recommended for everyone older than age 26 years. However, some adults ages 27 through 45 years who aren’t already vaccinated may decide to get the HPV vaccine after speaking with their doctor about their risk for new HPV infections and the possible benefits of vaccination. HPV vaccination in this age range provides less benefit, as more people have had previous HPV exposure.
  • If vaccination begins before age 15 years, a 2-dose schedule is recommended, with doses spaced out between 6 to 12 months. For those beginning the series after their 15th birthday, the vaccine is a 3-shot series.

HPV vaccination prevents new HPV infections but does not treat existing infections or diseases. Therefore, the HPV vaccine works best when given before any HPV exposure occurs. You should get screened for cervical cancer regularly, even after receiving the HPV vaccine.

Both the Pap test and the HPV test can help prevent cervical cancer or locate cervical cancer early.

The CDC recommends:

  • Pap tests should commence at age 21 years. If you have a normal result, your practitioner may say you can wait 3 years until your next Pap test.
  • If you are ages 30 to 65 years you should discuss the following testing options with your Capital Women’s Care practitioner:
    • A Pap test only. If your result is normal, your doctor may tell you that you can wait 3 years until your next pap test.
    • An HPV test only. This is called primary HPV testing. If your result is normal, your doctor may tell you that you can wait 5 years until your next screening test.
    • An HPV test along with the Pap test. This is called co-testing. If both results are normal, your doctor may tell you that you can wait 5 years until your next screening test.
  • If you are over age 65 years, your Capital Women’s Care practitioner may inform you that you don’t need to be screened anymore if:
    • you have had normal screening test results for several years, or
    • you had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids.

Many older women don’t realize the risk of developing cervical cancer continues, even as they age. More than 20% of cervical cancer cases occur in women aged 65+ years; however, these cancers rarely occur in women who receive regular recommended cervical cancer screening tests before age 65.

Cervical Cancer Risk Factors

There are several risk factors that have been proven to increase cervical cancer risk:

  • Having Sexually Transmitted Infections (STIs) like HIV/AIDS, chlamydia, gonorrhea or syphilis. Women living with HIV are 6 times more likely to develop cervical cancer compared to women without HIV.
  • Having a family history of cervical cancer, which doubles or triples your personal cervical cancer risk.
  • Smoking. Smoking is associated with squamous cell cervical cancer.
  • Having sexual intercourse early.
  • Were under age 17 years during a first full-term pregnancy.
  • Using birth control pills for 5 or more years.
  • Giving birth to 3 or more children.
  • Having several sexual partners.
  • Having sexual intercourse without using a condom.
  • Exposure to miscarriage prevention drug diethylstilbestrol (DES.) If your mother took DES while pregnant in the 1950s, you may have an increased risk of clear cell adenocarcinoma, a rarer type of cervical cancer.

Cervical Cancer Symptoms

It’s important to note early-stage cervical cancer generally produces no signs or symptoms.

By the time signs and symptoms appear, cervical cancer is often at a more advanced stage, offering a bleak 17% chance of a 5-year survival rate. Cervical cancer detected early enough has a five-year survival rate of over 90%.

Signs and symptoms of more-advanced cervical cancer include

  • vaginal bleeding after intercourse, between periods or after menopause.
  • watery, bloody vaginal discharge that may be heavy with a foul odor.
  • and/or pelvic pain or pain during sexual intercourse.

Make an appointment with your local Capital Women’s Care practitioner right away if you experience any signs or symptoms that concern you.

Cervical Cancer Diagnosis

If cervical cancer is suspected, your practitioner may use a colposcope, a special magnifying instrument to check for abnormal cells.

During a colposcope examination, your doctor may perform a biopsy to gather cervical cell samples for testing. To obtain tissue, your doctor may use:

  • punch biopsy to pinch off small cervical tissue samples.
  • endocervical curettage to scrape tissue sample from the cervix.

If either causes further concern, your doctor may initiate further tissue sampling using an electrical wire loop under local anesthesia done in-office, or cone biopsy of deeper cervical cell layers done in a hospital while under general anesthesia.

Cervical Cancer Staging

Staging determines course of treatment should cervical cancer present. Imaging tests (X-ray, CT, MRI and positron emission tomography (PET) help your doctor determine whether cancer spread beyond the cervix. Visual exams of both bladder and rectum via special scopes determines if cancer has metastasized, or spread, beyond the cervix.

Cervical Cancer Treatment

There are several treatment options available. The options may be prescribed singly or in combination depending on personal health history, the stage of cervical cancer and current general health:

  • Surgery is usually used in early-stage cervical cancer. The operation best for you depends on tumor size, its stage and whether you’re considering pregnancy. Talk with your specialist to determine the best option for you.
  • Radiation therapy is often combined with chemotherapy as primary treatment for locally advanced cervical cancers. It can also be used after surgery if there’s an increased risk the cancer will return. It may be given externally, internally or in combination.

    If menopause hasn’t yet started, radiation therapy might cause it to occur. If you want to consider becoming pregnant after radiation treatment, ask your doctor about preservation of your eggs before any treatment commences.

  • Chemotherapy can be given through a vein or taken in pill form. Sometimes both methods are used.

    For locally advanced cervical cancer, low chemotherapy doses are often combined with radiation therapy. Higher chemotherapy doses may be recommended to control very advanced cancer symptoms.

  • Targeted therapy focuses on specific weaknesses present within cancer cells. By blocking these weaknesses, targeted drug treatments can cause cancer cells to die. Targeted drug therapy is usually combined with chemotherapy. It might be an option for advanced cervical cancer.
  • Immunotherapy is a drug treatment that helps the immune system to fight cancer. The body’s disease-fighting immune system might not attack cancer because the cancer cells produce proteins that make them undetectable by immune system cells. Immunotherapy works by interfering with that specific process. For cervical cancer, immunotherapy might be considered when the cancer is advanced and other forms of treatment aren’t working.
  • Supportive (palliative) care is specialized medical care that focuses on providing relief from pain and other symptoms. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support complementing ongoing care. When palliative care is used along with all other appropriate treatments, those diagnosed with cancer may feel better and live longer.

    Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments.

New Research Offers Hope

Researchers continue to analyze cervical cancer cell behaviors to explore innovative treatments relating to advanced cervical cancer. Two new studies from Washington University School of Medicine in St. Louis have identified a previously unrecognized pathway of cell death (lysoptosis) and demonstrate how it could lead to new cervical cancer therapies.

Research is also moving forward to identify additional immunotherapies, targeted therapies and supportive palliative care used in cervical cancer treatment.

As steadfast cervical cancer research continues, more care and treatment options are certain to become available for those women diagnosed to offer them more quality, prolonged lives.

Adhering to recommended risk prevention, including getting regular recommended screenings and vaccinating against HPV, offer you best protection against cervical cancer. Your Capital Women’s Care team of healthcare professionals is here to answer your questions and address your concerns relating to your cervical health or any women’s health issue. Our community of expert doctors, practitioners and health specialists offer you comprehensive quality care and treatment, so you enjoy optimal health and a long, quality life.