Screening and education can make all the difference
Article Provided by Bonner General Health
In recognition of Cervical Cancer Awareness Month, we asked Bonner General Family Practice Provider Dr. Tessa Reinke to share her expertise on this invasive yet preventable disease.
Dr. Reinke, tell us about cervical cancer and its cause.
Cervical cancer is the fourth most common cancer in women worldwide, but the majority of those cases happen in resource-limited settings. In parts of Africa and Central America, cervical cancer is the leading cause of cancer-related death in women.
The human papillomavirus (HPV) is a causative agent in the vast majority (99.7 percent) of all invasive cervical cancers. Most sexually active women (estimated 70 to 80 percent) will have had a genital infection with HPV before the age of 50, but thankfully, most of these are brief, and the body clears the infection. The big concern comes when the virus is persistently present, and the body can't clear it. This viral persistence is what is associated with the development of cancer over the years. The time from initial infection to invasive cancer, on average, is about 15 years, although the timeline can be much faster. There is a lot of time when the virus is detectable and causes cells to be abnormal on the cervix before the abnormalities become actual cervical cancer.
The HPV virus can also cause other types of genital area cancers, including vaginal and penile cancers, as well as genital warts.
What are the best preventative measures for women to decrease their risk of cervical cancer?
Since HPV primarily causes cervical cancer, the first layer of protection we have is being vaccinated with the HPV vaccine prior to first sexual contact. The vaccine helps to establish immunity to the most oncogenic (cancer-causing) HPV subtypes and makes it easier for the body to clear the virus when it is exposed and prevent persistent infection.
Since HPV is a sexually transmitted virus, other preventive measures include delaying sex and limiting the number of sexual partners. Along the same line, avoiding other sexually transmitted infections is an essential preventive factor, since co-infection with some STIs appears to be associated with a higher risk of HPV persistence. Also, there is a recent study that showed cigarette smoking is correlated with an increased risk of cervical cancer development, although the reason for this has not been established.
Regular screening is also an important prevention method. Since cervical cancer takes so long to develop, if we screen regularly, we can detect and treat a persistent HPV infection before it becomes actual cancer.
At what age should women begin cervical cancer screenings? Additionally, is there an age you no longer need to worry about screening?
The American College of Obstetricians and Gynecologists recommends starting cervical cancer screening at age 21, and it's generally accepted that the screenings can end after age 65. However, if the individual is healthy and has a longer-than-average life expectancy and new risk factors, like a new sexual partner, it may be prudent to continue screening after age 65.
Talk with your Primary Care Provider about cervical cancer screening and when you should start.
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