Cervical Cancer 101

Cervical cancer used to be one of the leading cause of cancer-related death for women in the United States. However, the incidence of cervical cancer has decreased by more than 60% in the last 50 years thanks to widespread screening with pap smears. Most cases of cervical cancer is caused by the Human Papilloma Virus (HPV). A recent study has shown that the HPV vaccination has decreased the prevalence of vaccine-type HPV infection by 56% in female teenagers 14-19 years of age.

What is cervical cancer?

The cervix is a narrow canal that makes up the lower part of the uterus (the womb). It sits on top of the vagina.

What is HPV?

Almost all cases of cervical cancer are caused by the Human Papilloma Virus (HPV). Seventy percent of all cases of cervical cancer are caused by two HPV types, HPV 16 and 18.

How can you get HPV?

HPV is sexually transmitted and HPV infection is much more common than one may think. Anyone who has ever been sexually active (vaginal, anal or oral sex) can get HPV and most people get HPV shortly after becoming sexually active for the first time, even if they’ve only had one partner.

If you’ve had the HPV vaccine, do you still need pap smears?

The HPV vaccine protects against HPV 16 and 18 (responsible for 70% of all cases of cervical cancer) in addition to HPV 6 and 11 which are responsible for 90% of genital warts. However, it is still important to get pap smears because there are other types of HPV that can cause cervical cancer that are not included in the vaccine.

How often do you need pap smears?

Up until 2012, the U.S. Preventative Task Force recommended annual pap smears within 3 years of sexual activity, and to begin pap smears no later than 21 years of age. However, the current recommendation is for women aged 21 to 65 years to get a pap smear every 3 years, regardless of sexual activity.

Once you become 30 years old, you have the option to lengthen the screening interval to 5 years by doing a combined pap smear and HPV test. The rationale for HPV testing at 30 years old is that HPV infection is very common in people under 30 years old, and if abnormal cervical cells were present, the body almost always naturally clears them up on its own.

Do you still need to get pap smears if you’ve never had sex?

While your risk for developing cervical cancer may be lower if you’ve never had sex, it is not completely protective. There are other factors that may contribute to your risk, such as a genetics, a weakened immune system, using combined oral contraceptives (“the pill”), smoking, and exposure to a drug called diethylstilbestrol (DES) before birth, among others.

Vivian is currently a fourth year medical student at UC Davis and will be applying to ophthalmology residency this year. She graduated from UC Berkeley with a major in Public Health and a minor in Global Poverty. She has a Master’s degree in Clinical Research from UC Davis and has just completed a year as a T32 Pre-Doctoral Research Fellow, a program supported by the National Institutes of Health, and UC Davis Clinical and Translational Science Center.

Main Photo Credit:  Chinnapong/shutterstock.com; Second Photo Credit:  chrupka/shutterstock.com; Third Photo Credit: Andrei Rahalski/shutterstock.com