Vital Signs: Cervical cancer awareness

Cervical cancer has been one of the great success stories in cancer research. We know what causes it. We know the risk factors for it. And we know that early detection and prevention efforts potentially could eradicate it.

Cervical cancer grows slowly, so with appropriate screening, most women who develop it — or are on the path to developing it — can be easily diagnosed and cured. But too often, women will look after others at their own expense. They’ll put off getting a Pap test for years, even decades, or they will see their doctors only after experiencing symptoms of advanced cervical cancer.

January is National Cervical Cancer Awareness Month, so it’s a good time to think about cervical cancer and the simple ways we can prevent it.

About cervical cancer

Cervical cancer affects the lower portion (the opening) of the uterus. It is caused almost exclusively by human papillomavirus (HPV). There are hundreds of types of HPV viruses that infect skin surfaces, and a specific subset of these HPV viruses spreads through sexual contact and causes cervical cancer and precancer. These viruses are incredibly common; most people harbor them at some point, and most are cleared by the body’s immune system.

There is typically a long latent phase between HPV exposure and the development of the precancerous condition known as dysplasia. The length of time it takes cervical cancer to develop gives us a broad opportunity to detect dysplasia and prevent its further growth via treatment. For this early detection, regular Pap tests are essential; however, with the advent of vaccinations, prevention would be preferable.

Since the Pap test was introduced in the 1940s, there has been an 80 percent reduction in cervical cancer in the U.S. And the recent arrival of HPV vaccinations should drive the number of cases even lower.

Potential eradication

The federal government approved the first HPV vaccine in 2006. Vaccination doesn’t provide complete cancer protection, but it targets and protects against the two types of HPV virus (HPV 16 and 18) that account for the vast majority of cervical dysplasia and cancer. Additionally, one of the vaccines available also protects against the HPV viruses that cause genital warts.

HPV is exceptionally widespread among sexually active adults, so it’s vital that girls be vaccinated before their first sexual contact. I recommend vaccination around the time girls are entering middle school, but it can be given anytime between ages 9 and 26. Three injections are required, and the vaccine is available to both girls and boys.

Some parents have expressed concern about the safety of the vaccines and fears that vaccination could encourage sexual activity in teenagers. In terms of safety, the vaccines have been tested exhaustively, with more than 100,000 people being vaccinated in clinical trials prior to the vaccines’ approval by the Food and Drug Administration. And that number is dwarfed by the number vaccinated since 2006.

The issue of teen sexual activity is something for each family to address. But too often teens fail to think through the potential consequences of sexual activity. It is unlikely they are considering their vaccination history or the reduced risk of cervical cancer in the heat of the moment.

As parents, we all hope our children will make smart choices. But we also know that we want the utmost protection for them in case they don’t. It’s for that reason I believe HPV vaccination is vital. It could save your daughter’s life.

Staying vigilant

Women older than 21 should be getting Pap tests regularly. Consult with your doctor to determine how often testing is appropriate, but, speaking generally, women older than 30 who are HPV-negative and have a history of normal Pap tests need to be screened only once every two to three years.

Both testing and the HPV vaccine are available at the University of Virginia Health System. Our doctors can provide you with the latest information on cervical cancer, and we offer a full spectrum of care for its prevention and treatment.

By getting your daughters vaccinated and by taking simple steps to look after your own health, you can be part of the huge success story that has been the battle against cervical cancer.

Dr. Susan Modesitt is the director of the Gynecologic Oncology Division in the Department of Obstetrics and Gynecology at the University of Virginia Health System.

Visit uvahealth.com for more information about cervical cancer.