During National Cervical Cancer Awareness month, January serves as a time to educate patients about cervical cancer, human papillomavirus (HPV), and the importance of screening even amid the COVID-19 pandemic. This month is an opportunity to remind patients to prioritize routine screenings that can detect cervical cancer early on and potentially save a life.
Every year, cervical cancer impacts more than 13,000 women nationwide. With today's research and knowledge at our finger tips, it's imperative that your patients know about all of the ways we can detect and prevent types of cervical cancer in women.
1. Explain the connection between HPV and cervical cancer
An estimated 79 million people in the United States are infected with HPV. This is typically from anal, vaginal, or oral sex—but in some cases, HPV can also be transmitted through skin to skin contact. In most cases, the body's immune system fights against the virus, and it clears on its own without any signs or symptoms. This is precisely why the virus is so easily transmitted from person-to-person without knowing.
For those immune systems that can't fight the virus, it can be much more severe. In some circumstances, HPV can cause warts on the genitals or surrounding skin and lead to cancers in both men and women. The most common is cervical cancer in women. It isn't clear what causes cervical cancer—but it is known that different strains of HPV lead to most cases of cervical cancer.
2. Inform patients on prevention and detection
Since there is no cure or treatment for HPV, early detection is critical through pelvic exams, Pap tests, and HPV tests. For women age 21 to 29, health.gov recommends getting screened with a Pap test every 3 years. For women aged 30 to 65, it's recommended to choose one of the three options below:
- Get screened every 3 years with a Pap test
- Get screened every 5 years with an HPV test
- Get screened every 5 years with both a Pap test and an HPV test
Some doctors may suggest more frequent testing when a patient has an abnormal test result.
To protect children early on, it's crucial to educate younger patients on the importance of practicing safe sex and getting the HPV vaccination. The CDC recommends routine vaccination for both males and females starting around age 11 or 12. While it's best for children to get vaccinated earlier, teens and young adults can be vaccinated until the age of 26. In specific cases, you may recommend vaccination for adults aged 27-45—although the vaccination is less effective since they have most likely already been exposed to HPV by this age.
3. How to answer patients when they ask "is the vaccine safe?"
HPV infections and cervical precancers have dropped significantly since the vaccine has been used in the United States.
- Among teen girls, infections with HPV types that cause most HPV cancers and genital warts have dropped 86 percent.
- Among young adult women, infections with HPV types that cause most HPV cancers and genital warts have dropped 71 percent.
- Among vaccinated women, the percentage of cervical precancers caused by the HPV types most often linked to cervical cancer has dropped by 40 percent.
More than 12 years of monitoring and research have shown that HPV vaccination is safe and effective. For more information on the efficacy of HPV vaccinations, guide patients to visit the CDC.
4. Explain the symptoms and who's most at risk
Since most people don't show symptoms, signs of cervical cancer are only detected from a pelvic exam and a Pap test. However, in some cases, increased discharge and unusual bleeding can be indicators. Pain during or after sex and bleeding post-menopause are also symptoms worth mentioning.
According to preventcancer.org, more than 13,200 women are diagnosed with invasive cervical cancer every year, and more than 4,200 die from the disease. Those women who are especially at risk for cervical cancer include women who
- are over 30 and have a human papillomavirus (HPV) infection that hasn't cleared
- began having sex at an early age and/or have multiple sex partners
- do not have regular cervical screenings—because without screenings, you can't have early detections
- smoke—smoking is associated most with squamous cell cervical cancer
- using birth control pills for a long time
- have weakened immune systems, including women who have the human immunodeficiency virus (HIV)
- are overweight or obese
- have a close relative, such as a sister or mother, who has had cervical cancer
- were exposed to diethylstilbestrol (DES) before birth—the common synthetic form of female estrogen commonly prescribed to pregnant women from 1940-1971 to prevent miscarriage, premature labor, and pregnancy complications
5. Discuss treatment for cervical cancer
Although there isn't a cure for HPV, there are treatment options for cervical cancer. When discovered early, the 5- year survival rate for women with invasive cervical cancer is 92%.