January is Cervical Cancer Awareness Month

Now is a good time to remind all women that cervical cancer is almost completely preventable with a vaccine and highly treatable if caught early. In the U.S. the number of women being diagnosed with invasive cervical cancer is low compared to other cancer types, and continues to trend down every year.

Approximately 12,000 women in the U.S. get diagnosed with invasive cervical cancer each year and 4,000 will die from it. These relatively small numbers are due to the widespread use of Pap smears, which identify abnormal cells in the lining of the cervix before they turn cancerous.

In other parts of the world though, where Pap smears are not so commonplace, cervical cancer is deadly and kills about 260,000 women worldwide every year.

Nearly all women with cervical cancer have been infected with human papillomavirus (HPV). HPV is the virus that can cause genital warts. According to the CDC, HPV is so common that nearly all sexually active women (and men) will get it at some point in their lives.

In most people, HPV will clear up on its own, except in about 10 percent of cases. Women among these 10 percent may develop a condition called cervical dysplasia, in which abnormal cell growth occurs on the surface lining of the cervix.

Early stages of cervical dysplasia are very treatable, but women must go for their regular Pap smears and HPV tests to identify if they fall into that 10 percent. Depending on the stage of dysplasia,  there are a variety of procedures that can remove the precancerous cells.

Left unchecked, cervical dysplasia can develop into cervical cancer. Most cervical cancer takes years to develop, but in some cases, it can progress much faster and be deadly.

The takeaway? If you are between 21 and 65, get your regular Pap smear and HPV tests! Specifically, Dr. Courtney Seacat, an OB/GYN at INTEGRIS, recommends:

• All women at average risk for cervical cancer should have Pap smears starting at age 21. Women between ages 21 and 29 should have a Pap smear every three years.
• Women between the ages of 30 and 65 should have a Pap smear plus an HPV test (called co-testing) every five years.
• Women at increased risk for cervical cancer (because they've had abnormal Pap smear results in the past or have tested positive in the past for HPV) may need screenings more often and should discuss their risk factors with their doctor.

However, just as important as detecting precancerous cells at an early stage through screenings is preventing them from occurring at all. There is an HPV vaccine that has been proven to be a safe, effective prevention strategy against cervical, vaginal, anal and penile cancers when given to girls and boys around the age of 11 or 12, when studies have shown a preteen’s immune response is more resilient than that of a teenager.

“The HPV vaccine is most effective if given to a person BEFORE he or she becomes sexually active and has not yet been exposed to high-risk HIV strains,” says Dr. Julie Hansen, an OB/GYN at INTEGRIS.

Unfortunately, vaccination rates in Oklahoma and the U.S. are low, perhaps due in part to fears that giving the HPV vaccine will make teenagers more likely to have sex (although there is no evidence that this is accurate). However, the HPV vaccine, which has been available for about 10 years, is working: studies show there has been a sharp decline in the number of U.S. women who enter adulthood infected with HPV.

The study found the infection rate of the four different HPV strains targeted by the Gardasil vaccine dropped 64 percent in teenage girls and 34 percent in women their early 20s.

This a great news. Because fewer young women are getting HPV, there will be fewer cases of genital warts and pre-cancers for women in their 20s, which will result in less cervical cancer as these women age.

Some have expressed concern about the science behind the vaccine and its safety and side effects, but Dr. Hansen strongly believes the vaccine is safe.

She says, “The Centers for Disease Control and the American Academy of Pediatrics recommend HPV vaccination of both girls and boys at ages 11 or 12 years and suggest that clinicians strongly recommend HPV vaccination for preteens and teens who have not yet been fully vaccinated.”

“Approximately 79 million doses of HPV vaccines have been distributed for use in the U.S. and no links between HPV vaccines and atypical or unusual pain syndromes, autonomic dysfunction or autoimmune disorders have been identified in clinical trials and safety monitoring conducted by the CDC," she continues. "Many other published studies available for review on the internet support the statement that the HPV vaccine is safe.”