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Learn More About Cervical Cancer Prevention

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It's been nearly 40 years since President Nixon declared the "War on Cancer." And while we've made great strides in screening, diagnosis and treatment, it is a rare cancer against which we've actually "won" the battle. More and more, however, it's looking like cervical cancer may be that cancer.

In 2008, there were an estimated 11,070 new cases of cervical cancer and 3,870 deaths, about 1 percent of all cancer deaths in women. This represents a 50 percent drop in cervical cancer incidence and deaths in the past 30 years, thanks to improved screening and early treatment. While such a drop is an amazing improvement, we are not yet where we need to be, particularly when it comes to minority women.

African-American women are 30 percent more likely to develop cervical cancer and twice as likely to die from it as Caucasian women. In addition, Hispanic women are twice as likely to develop cervical cancer, with 3 percent of all cancer deaths in Hispanics due to cervical cancer.

The numbers are even bleaker when you leave the United States. Although the global incidence and death rates of cervical cancer have plummeted 75 percent in the past 50 years in developed countries, cervical cancer remains the second most common cause of cancer and cancer deaths among women in developing countries, with a 55 percent mortality rate (compared to rates below 5 percent for most women in the United States). In fact, the World Health Organization reports that 83 percent of all cases of cervical cancer worldwide occur in developing countries.

This shows the importance of screening and prevention, which often isn't available in developing countries. In the United States, however, low-income, uninsured and medically underserved women have access to the state and federally funded National Breast and Cervical Cancer Early Detection Program, which covers cervical and breast cancer screenings. For information on a participating clinic in your area, go to http://www.cdc.gov/cancer/nbccedp.

HPV Testing: Is it for You?

Although most women know how often they should have a Pap smear (hint: typically once a year), when was the last time you were tested for the human papillomavirus (HPV)? Should you even be tested for the virus?

The answer is … it depends.

While the Pap test evaluates cells from your cervix for any abnormalities, including precancerous and cancerous changes, the HPV test identifies genetic material from the 13 most common types of HPV that cause those changes. A sample for both tests can be collected at the same time, and the same sample can even be used for both tests.

However, the test is only recommended for women 30 and older. Younger women shouldn't be screened because the virus is so common and widespread and cervical cancer so rare in women under 30 that identifying the virus wouldn't mean anything. And while the test itself is painless with no risks, it does carry a financial cost. Most insurance companies cover the HPV test, as long as it is provided within recommended guidelines. Some states require that insurers cover the cost.

Whether you should get tested is between you and your health care professional, so be sure to discuss the test. The American Society for Colposcopy and Cervical Pathology and the American Cancer Society currently recommend routine HPV screening for women 30 and older.

You should consider screening even if you received the HPV vaccine when you were younger. The vaccine does not protect against all forms of cancer-causing HPV. We also don't know how long its protection will last.

If you are 30 or older and your HPV test is negative, breathe a sigh of relief and move on. A negative test means you do not have the virus; if you were infected at some point, your body got rid of it. The negative test also means you don't need another Pap or HPV screening for three years because without any evidence of long-term infection with the HPV, it's highly unlikely you'll develop cervical cancer.

If your test was positive, however, don't panic! It does not mean you have cancer. Remember: HPV is a very common virus. In fact, most women will have HPV at some point in their lives, if they are sexually active, but very few will develop cervical cancer. Most of the time, your immune system gets rid of HPV. If your Pap was normal, you don't need to do anything except have another HPV test in 12 months to see if your body has shed the virus. There is no treatment for HPV.

At follow-up testing, if you still have the virus or if your Pap test results are inconclusive or abnormal, your health care professional may want to examine your cervix more closely to be sure there are no cellular changes.

If your HPV test was positive and the Pap smear was inconclusive or abnormal, your health care provider will likely conduct additional tests to confirm the findings. You may need a colposcopy, in which the cervix is examined under a bright light, and/or a biopsy.

Once you pass age 70 or have had a total hysterectomy (in which the cervix was removed) for reasons other than cancer, you may no longer need a Pap or HPV test. Discuss with your health care provider how long you should continue to get screened.

Be sure to ask your health care professional questions if you have worries or concerns about your HPV test results and so you understand his or her recommendations for next steps. An HPV infection isn't anything to be ashamed of and it doesn't mean your partner has been unfaithful. The virus can persist in your body for quite a while: years, in fact; that's why screening is so important.

HPV is spread by direct genital contact during vaginal or anal intercourse, so if you have HPV, it's possible to infect your partner. Using condoms correctly and every time you have sex may reduce your risk of being exposed to or transmitting HPV, but the virus can live on areas the condom can't cover. So, the only way to make sure you don't infect a partner is to not have any type of sexual contact, including oral and anal sex, until your body sheds the virus on its own.

According to the American Society for Colposcopy and Cervical Pathology, most sexually active couples will share the HPV infection until your immune system gets rid of it. Partners who are sexually intimate only with each other do not pass the same virus back and forth. When the infection goes away, your immune system remembers it and will prevent a new infection with the same HPV type from recurring. However, because there are many different types of HPV, becoming immune to one HPV type may not protect you from getting HPV again if you are exposed to another HPV type.

Three Shots Is All It Takes

There's been a lot of publicity lately about the vaccine designed to protect adolescents and young women against the human papillomavirus (HPV). Is it safe? Is it cost effective? Is it effective? The answer to all those questions is yes. But here's the thing that seems to get lost in many discussions about the vaccine—it is the first effective vaccine in the world that protects against cancer. Yet because the viruses that cause cervical cancer are mainly spread via sex or sexual acts, some think that vaccinating young girls is paramount to handing them a condom and telling to "go for it."

Nothing could be further from the truth. The reality is that the HPV vaccine, Gardasil, has been studied in more than 10,000 women, and there is no evidence that it spurs girls to become sexually active. In fact, research finds that girls who receive the vaccine are less likely to become sexually active.

Despite lingering questions about the vaccine, girls are getting their shots. The U.S. Centers for Disease Control and Prevention (CDC) reported in September 2008 that one in four teenaged girls had received the three-dose vaccine.

Other key facts about the vaccine:

• The CDC's Advisory Committee on Immunization Practices and the American College of Obstetricians and Gynecologists recommends the HPV vaccine for girls and women ages 9 to 26 years. It is specifically recommended for 11- and 12-year-old girls, who are most likely not infected with genital HPV viruses.
• You do not need to be pretested for HPV before being vaccinated, and you can be vaccinated even if you are currently infected with HPV (although the vaccine is less effective).
• The HPV vaccine is also approved for protection against vulva and vaginal cancers.
• You still need regular Pap tests and if you are 30 or older, HPV tests, even after you're vaccinated against HPV because there is a very tiny chance you could still develop cervical cancer (the vaccine protects against the viruses responsible for 70 percent of cervical cancers).
• Just one state (Virginia) currently mandates the vaccine for school admission, but at least a dozen others are considering it.
• Although the vaccine's protection lasts at least five years, women may eventually need a booster.


World Health Organization. 10 Cancer Facts. 2006. Available at: http://www.who.int/features/factfiles/cancer/05_en.html. Accessed October 21, 2008.

Carr J, Gyorfi T. Human papillomavirus. Epidemiology, transmission, and pathogenesis. Clin Lab Med 2000;20(2):235-55.

de Sanjose S, Diaz M, Castellsague X, et al. Worldwide prevalence and genotype distribution of cervical human in women with normal cytology: a meta-analysis. Lancet Infect Dis. 2007;7(7):453-9.

Wright TC, Schiffman M. Adding a test for human papillomavirus DNA to cervical-cancer screening. N Engl J Med. 2003;348(6):489-90.

Workowski KA, Berman SM. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recomm Rep. 2006;55(RR-11):1-94.

Cox JT. The development of cervical cancer and its precursors: what is the role of human papillomavirus infection? Curr Opin Obstet Gynecol. 2006;18(Suppl 1):s5-s13.

American Cancer Society - Cancer Facts & Figures 2008. At: http://www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf. Accessed October 19, 2008.

Tarkowski TA, Koumans EH, Sawyer M, et al. Epidemiology of human papillomavirus infection and abnormal cytologic test results in an urban adolescent population. J Infect Dis 2004;189(1):46-50.

Winer RL, Feng Q, Hughes JP, et al. Risk of female human papillomavirus acquisition associated with first male sex partner. J Infect Dis. 2008;197(2):279-82.

Chin-Hong PV, Vittinghoff E, Cranston RD, et al. Age-specific prevalence of anal human papillomavirus infection in HIV-negative sexually active men who have sex with men: the EXPLORE study. J Infect Dis 2004;190(12):2070-6.

Partridge JM, Hughes JP, Feng Q, et al. Genital human papillomavirus infection in men: incidence and risk factors in a cohort of university students. J Infect Dis 2007;196(8):1128-36.

Fazel N, Wilczynski S, Lowe L, Su LD. Clinical, histopathologic, and molecular aspects of cutaneous human papillomavirus infections. Dermatol Clin 1999;17(3):521-36, viii.

Beutner KR. Nongenital human papillomavirus infections. Clin Lab Med 2000;20(2):423-30.

Sedlacek TV. Advances in the diagnosis and treatment of human papillomavirus infections. Clin Obstet Gynecol 1999;42(2):206-20.

Tilston P. Anal human papillomavirus and anal cancer. J Clin Pathol 1997;50(8):625-34.

Mandell, Gerald L, John E. Bennett, and Raphael Dolin. Principles and Practice of Infectious Diseases, 6th ed. (Philadelphia: Churchill Livingstone, 2005).

Abed Z, O'Leary M, Hand K, et al. Cervical screening history in patients with early stage carcinoma of the cervix. Ir Med J. 2006;100(1):140-2.

Janerich DT, Hadjimichael O, Schwartz PE, et al. The screening histories of women with invasive cervical cancer, Connecticut. Am J Public Health. 1995;85(6):791-4.

Coleman DV, Poznansky JJ. Review of cervical smears from 76 women with invasive cervical cancer: cytological findings and medicolegal implications. Cytopathology. 2006;17(3):127-36.

Why FDA Approval Matters. ThinPrep. Available at: http://www.thinprep.com/info/why_pap_test/fda_approved.html. Accessed October 21, 2008.

Abulafia O; Pezzullo JC; Sherer DM. Performance of ThinPrep liquid-based cervical cytology in comparison with conventionally prepared Papanicolaou smears: a quantitative survey. Gynecol Oncol. 2003;90(1):137-44.

Sulik SM, Kroeger K, Schultz JK, et al. Are fluid-based cytologies superior to the conventional Papanicolaou test? A systematic review. J Fam Pract 2001;50(12):1040-6.

Datta SD, Koutsky LA, Ratelle S, et al. Human papillomavirus infection and cervical cytology in women screened for cervical cancer in the United States, 2003-2005. Ann Intern Med. 2008;148(7):493-50.

Saslow D, Runowicz CD, Solomon D, et al. American Cancer Society guideline for the early detection of cervical neoplasia and cancer. CA Cancer J Clin. 2002;52(6):342-62.

U.S. Preventive Services Task Force. Screening for cervical cancer: recommendations and rationale. Agency for Healthcare Research and Quality, Rockville, MD 2003. Available at: www.ahrq.gov/clinic/3rduspstf/cervcan/cervcanrr.pdf. Accessed October 19, 2008.

ACOG Practice Bulletin: clinical management guidelines for obstetrician-gynecologists. Number 45, August 2003. Cervical cytology screening (replaces committee opinion 152, March 1995). Obstet Gynecol. 2003;102(2):417-27.
Cancer Facts and the War on Cancer. National Cancer Institute. Available at: http://training.seer.cancer.gov/module_cancer_disease/unit5_war_on_cancer.html. Accessed October 21, 2008.

National Cancer Institute. A Snapshot of Cervical Cancer. Last updated: December 2007. Available at: http://planning.cancer.gov/disease/Cervical-Snapshot.pdf. Accessed September 19, 2008.

American Cancer Society. Cancer Facts and Figures for African Americans 2007-2008. At: http://www.cancer.org/downloads/STT/CAFF2007AAacspdf2007.pdf. Accessed September 19, 2008.

American Cancer Society. Cancer Facts and Figures for Hispanics/Latinos 2006-2008. At: http://www.cancer.org/downloads/STT/CAFF2006HispPWSecured.pdf. Accessed September 19, 2008.

Parkin DM, Pisani P, Ferlay J. Global cancer statistics. CA Cancer J Clin. 1999;49:33.

Kim JJ, Goldie SJ. Health and economic implications of HPV vaccination in the United States. N Engl J Med. 2008; 359(8):821-32

Centers for Disease Control and Prevention. Information from FDA and CDC on Gardasil and Its Safety. July 22, 2008. Available at: http://www.cdc.gov/vaccinesafety/vaers/FDA_and_CDC_Statement.htm. Accessed October 19, 2008.

New York State Department of Health. Questions and Answers about Human Papillomavirus (HPV) Vaccine. Available at: http://www.health.state.ny.us/prevention/immunization/human_papillomavirus/. Accessed October 19, 2008.

Adult Immunization. Treat Guidel Med Lett. 2006;4:47.

Markowitz, LE, Dunne, EF, Saraiya, M, et al. Quadrivalent Human Papillomavirus Vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2007; 56:1.

Centers for Disease Control and Prevention. HPV Vaccine Information for Young Women. Last updated June 26, 2008. Available at: http://www.cdc.gov/std/Hpv/STDFact-HPV-vaccine.htm#hpvvac2. Accessed September 20, 2008.

Hendrix SL. Assessing Human papillomavirus Vaccine Efficacy and Safety. J Am Osteopath Assoc. 2008;108(suppl2):58-S12.

Rosenthal E. Drug Makers' Push Leads to Cancer Vaccines' Rise. NYT. August 19, 2008.
American Cancer Society: Thinking About Testing for HPV? Information for Women Considering Testing for the Human Papilloma Virus (HPV). Available at: http://www.cancer.org/docroot/CRI/content/CRI_2_6x_Thinking_About_Testing_for_HPV.asp.

HPV Testing: Is it for Me? American Society for Colposcopy and Cervical Pathology. Available at: http://www.asccp.org/pdfs/patient_edu/hpv_testing.pdf.

Wright TC Jr, Schiffman M, Solomon D, et al. Interim guidance for the use of human papillomavirus DNA testing as an adjunct to cervical cytology for screening. Obstet Gynecol. 2004 Feb;103(2):304-9.

Making sense of your PAP and HPV test results. Centers for Disease Control and Prevention. Available at: http://www.cdc.gov/STD/HPV/pap/default.htm.

Screening for Cervical Cancer. U.S. Preventive Services Task Force. January 2003. Available at: http://www.ahrq.gov/clinic/uspstf/uspscerv.htm.

Cervical Cancer Screening Guidelines. Centers for Disease Control and Prevention. Available at: http://www.cdc.gov/std/hpv/ScreeningTables.pdf.

© 2009 National Women’s Health Resource Center, Inc. (NWHRC) All rights reserved. Reprinted with permission from the NWHRC. 1-877-986-9472 (toll-free). On the Web at: www.healthywomen.org.

Add a Comment2 Comments

better protection than any vaccine, is monogamy

October 4, 2009 - 10:14am
EmpowHER Guest

I think US women are over-examined, over-screened, over-tested and over-treated to their detriment.
Finland has the lowest rates of cervical cancer in the world AND (just as importantly) the lowest number of women sent for biopsies and false positives.
In that country, screening is offered from age 30 and then 5 yearly until 60 (usually...sometimes 50 or 55...depending on past results and sexual history)
Testing young women and testing too frequently means more women being referred for biopsies for false positives.
Biopsies are not to be taken lightly...they can leave you with psychological/psychosexual problems, infertility, problems during preganancy & cause pre-term birth.
Annual gyn exams - unnecessary in asymptomatic women and in fact, my Dr believes they can be harmful (they can lead to more & possibly, harmful testing)
The States and Germany are the only countries who recommend these exams.
Breast exams are NOT recommended in many countries until your 40's, as earlier exams are very likely to lead to biopsies & cancer in the under 40's is uncommon.
Virgins are even tested in the States! I understand they're pressured to have annual gyn exams and smears. Virgins are not offered screening in any other country in the world - the risk to benefit ratio makes it unethical IMO...
Routine gyn exams are not recommended for asymptomatic women...virgins or not. (except in Germany)

I was very concerned to see the amount of medical intervention in the lives of US women and most of it so terribly unpleasant.
I'd look around the world....before I agreed to these exams and tests.
They can hardly be vitally important when the vast majority of the world's doctors don't recommend them at all.
Also, mammograms are recommended from age 40 in the States. In my country, they're offered from age 50...but more women are declining them due to the increasing evidence about the risks of testing.
Professor Michael Baum (UK breast cancer surgeon) is very concerned about the number of false positives and unnecessary surgery and treatment...also, the dilemma of ductal carcinoma in situ, a slow moving cancer that usually doesn't bother a woman...you'll die of something else first, but once biopsied, it can become aggressive..so usually it's discovery through screening, means the breast comes off...
Also, new research by the Nordic Cochrane Institute that suggests regular mammograms may INCREASE the risk of breast cancer...perhaps, it's the radiation and/or the damage to breast tissue.
Anyway, if you have mammograms, be careful about starting them before you're 50....

One other point...if you were both virgins and you're in a mutually monogamous relationship...you may choose not to have pap smears. You have to catch HPV from someone and you can't catch it from a virgin.
Most doctors just seem to push all women into testing...but when the test is unreliable and there is a high risk of a false positive and biopsies, then the decision whether to accept that risk, MUST rest with the woman.

There are risks as well as benefits with cancer screening...so it's important to know,
A) how common is the cancer,
b) your risk profile &
c) the risks of testing.
I then weigh up the risks v benefits before agreeing to the test.
As cancer screening is offered to healthy people, you must give your informed consent...no Dr
can push you into screening...it's unethical and possibly, more than that...
The practice in the States, of making cancer screening a pre-requisite for the Pill, is highly unethical...birth control has nothing to do with cancer screening...to require it, amounts to coercion IMO and is a violation of your right to decide...
This practice disregards the recommendations from WHO, the US Food and Drug Admin & the American College of Ob & Gyns...
Planned Parenthood now offer the HOPE program for women who wish to access the Pill without these
unethical requirements.
It is your decision whether you participate, when you start and finish and how often you're tested...
Do your reading, stand up for yourselves, make informed decisions and protect your health.
Good luck everyone....
PS I lived in the States for 2 years and so had the opportunity to compare your healthcare system with those of Finland, the UK and Australia
There are lots of articles on line that will help with your research.
I'd recommed articles by Angela Raffle, a UK cervical cancer screening expert...her research showed that 1000 women need regular screening for 35 years to save ONE woman from cervical cancer. Her articles in the British Medical Journal are definitely worth a read.

August 25, 2009 - 6:10pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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