Cervical Cancer Cervical cancer affects around 11,500 women each year. Of those women, nearly 25% lose their life to the condition. Cervical cancer is one of the five main reproductive cancers impacting women in the U.S. alongside ovarian, uterine (endometrial), vaginal and vulvar cancers. Active-duty service members and veterans are twice as likely to develop cancers associated with HPV. Cervical Cancer The Condition Screening and Results Risk and Prevention What Is Cervical Cancer? The cervix is the lower part of the uterus that connects to the vagina. Cervical cancer occurs when abnormal cells grow in the cervix. Human papillomavirus (HPV), the most common sexually transmitted infection (STI) in the U.S., is the main cause of cervical cancer. HPV is a common infection that may occur through sexual contact. Though your body’s immune system plays a role in eliminating the threat of HPV if contracted, a small percentage of HPV cases lead to cervical cancer. Cancerous cells divide and multiple rapidly, which may result in tumors. These cells can outlive healthy cells in the cervix, as well. Cancerous cell growth can go beyond the cervix and travel throughout the body, also known as metastasizing (i.e., spreading). When cancer spreads, it’s harder to treat. Routine screening, early intervention and treatment all increase your changes of reducing negative health outcomes. Are There Different Types of Cervical Cancer? Yes! There are two types of cervical cancer, and they are determined by cell shape. Though rare, cervical cancer can occur in both cell types at the same time. Squamous Cell Carcinoma is the most common. This starts in the thin, flat cells (squamous) lining the outer walls of the cervix. Adenocarcinoma begins in the column-shaped gland cells of the cervix and is less common. How Can I Check My HPV and Cervical Cancer Status? HPV vaccination doesn’t protect against all HPV types that can cause cervical cancer, so it is still important to receive routine screening. Common tests include HPV tests and a ‘Pap test’ or ‘Pap smear’. Both of these tests identify HPV infections and abnormal cell changes that can be treated before they turn into cancer. Ensure you are mission ready by attending routine screenings. If you are anticipating deploying when you are due for screening, be sure to get screened before you deploy. It may be harder to get tested and receive care while deployed. When Should I Get Screened? How often you get screened for cervical cancer and which test you should receive depends on your age and health history. Age 21-29 Years: It is recommended to receive your first Pap test at age 21*, followed by Pap testing every 3 years. Even if you are sexually active before age 21, you can wait until the recommended age to receive screening. *The American Cancer Society (ACS) recommends starting HPV/Pap co-testing at age 25. Age 30-65 Years: It’s recommended to screen using these methods: HPV test every 5 years HPV/Pap co-test every 5 years Pap test every 3 years Age 30-65 Years: Talk to your health care provider to find out if screening is still needed. If recent lab results were abnormal or you have not received regular screening, you may need to continue beyond age 65. Your health care provider may recommend more frequent cervical cancer screening if you: Are HIV positive Have a weakened immune system Had a recent abnormal cervical screening test or biopsy result Had cervical cancer previously Are sexually active without using protection What Can I Expect at My Screening? Cervical cancer screening is done during a pelvic exam. It only takes a few minutes. Your provider will explain each step before they perform the screening. For good measure and ease of mind, request this if you need to. Your health care provider may ask you to remove all of your clothes for a full physical exam or just the clothes on the lower half of your body. You can expect to lie on your back on an exam table, bend your knees and put your feet into supports. They may also do a breast exam at the same appointment to check for possible breast irregularities. Next, your provider will use a speculum, the device used to widen your vaginal opening, to see inside your cervix. They will use a small brush to collect a cell sample from your cervix. You may feel light pressure and some tickling during this screening process. Lastly, your sample is sent to a lab and analyzed. The sample can check for both cancer-causing HPV strains (HPV test) and abnormal cells (Pap test). Results typically come back in a few days but may take longer. Your provider will share the results with you and describe next steps, if necessary. What Should I Expect If I Get Positive or Abnormal Test Results? If you receive a positive HPV test or abnormal Pap test, you may will need further testing. Your provider may recommend: Repeat testing: Your provider may request you undergo a second HPV/Pap co-test. The timing of the second test may depend on when you had your initial test, your age and previous results. Colposcopy, biopsy and endocervical sampling: A colposcopy is a more thorough exam of your cervix with a magnifying scope. If an area of abnormal cells is visible, your provider may perform a cervical biopsy. A small tissue sample is taken and sent to a lab for testing. Endocervical (i.e., inside the cervix walls) sampling may also be done. A small brush or other tool is used to take a tissue sample from the cervical canal. Endometrial sampling: A sample of the uterine lining is collected for testing. What Are the Risk Factors? Smoking tobacco Smoking increases the risk of many cancers, including cervical cancer. Individuals who contract HPV and smoke tend to take longer to recover and increase their chances of HPV leading to cervical cancer. Secondhand smoke If you inhale secondhand smoke routinely, you are also at an increased risk. Risk increases as exposure increases. Increased number of sexual partners The more sexual partners you have, the higher your likelihood of getting HPV. Early sexual activity Having sex at an early age increases your risk of HPV. Other STIs Having an STI increases your likelihood of getting HPV. STIs that increase risk include herpes, chlamydia, gonorrhea, syphilis and HIV/AIDS. Weakened immune system If you live with a weakened immune system, it may take you longer to recover from STIs, including HPV. It also reduces your likelihood of fighting off infection. Reproductive factors Both oral contraceptives (birth control pills) and giving birth to multiple children are associated with increased risk of cervical cancer with HPV. Obesity Cervical cancer screening may be more difficult, which can lead to lower precancer detection rates and higher risk of cancer. Exposure to miscarriage prevention medicine If your parent took DES while pregnant, your cervical cancer risk may be increased. This medicine was most commonly used between 1940 and 1971 and is linked to clear cell adenocarcinoma. It is largely discontinued and no longer marketed in the U.S. How Can I Prevent HPV? There are a few steps you can take to reduce your risk of developing HPV and thereby, cervical cancer. Get vaccinated! HPV vaccines can prevent around 90% of cases of cervical, vaginal, vulvar and anal cancers. Encourage all sexual partners to also receive the vaccine. Learn more about HPV vaccination today. Use condoms. Consistent and proper condom use can protect you from infection. Avoid direct contact. Abstaining from sexual contact with another person is the only way to avoid all STIs and risk of pregnancy. Get tested. Follow screening guidelines and work with your health care provider to ensure you are receiving follow-up testing, if needed. ReferencesAmerican Cancer Society - “Cervical Cancer”Cleveland Clinic - “Cervical Cancer”Mayo Clinic - “Cervical Cancer”MedlinePlus - “Cervical Cancer”National Cancer Institute - “Cervical Cancer Screening”National Cancer Institute - “What Is Cervical Cancer?”TRICARE - “Cancer of Female Reproductive Organs (Screening)”
