Cancer of the cervix
Cancer of the cervix (the portion of the uterus that extends into the vaginal cavity) is the third most common gynecologic cancer. Cancer of the cervix is caused by infection with the human papillomavirus (HPV). Cervical cancer typically develops over the long term from abnormal precancerous (before-cancer) cells on the surface of the cervix. These abnormal cells transform into cervix cancer over a number of years. After turning cancerous, these cancer cells can invade or spread to other parts of the body.
Screening tests
Pap test also known as Pap smear
A Pap test is a simple, quick office test in which a sample of cells from a woman's cervix is collected by aspiration or swabbing and spread (smeared) on a microscope slide. The cells are examined under a microscope in order to look for precancerous (before-cancer) or cancer cells.
Who to test and how often
Women should have yearly Pap tests as part of a manual pelvic examination beginning at age 18. Because the risk of cervical cancer increases sharply in the first few years after sexual activity beings, some physicians begin screening women as soon as they become sexually active, but not before. High-risk factors for cancer of the cervix include:
- cigarette smoking
- previous genital warts or other genital infection with the human papilloma virus (HPV)
- multiple sexual partners or a partner who has multiple sexual partners
- onset of sexual activity at a young age
After two normal Pap tests, women in bilateral monogamous relationships may decrease the frequency of Pap tests to once every two to three years.
It is rare to find pre-cancer or cancer of the cervix in women over age 65 who have repeatedly had normal Pap smears, so many doctors stop screening in women over age 65 who have had consistently normal Pap smears. Other doctors decrease the frequency of Pap screening under these circumstances.
Women who have had a hysterectomy (surgery to remove the uterus, including the cervix) no longer require a Pap test, but they should continue with manual pelvic and rectal examinations by their doctors as a part of their periodic medical evaluations for reasons other than cancer of the cervix.
Benefits of early detection
There has been a 70% decrease in the deaths from cancer of the cervix by regular use of the Pap test. Benefits of the Pap test include:
- Pap tests can prevent cancer of the cervix by identifying and allowing treatment of abnormal cells before they become cancerous.
- Pap tests can identify cancer of the cervix at an early curable stage, before cancer cells spread (metastasize) to other parts of the body.
Prevention
A vaccine (Gardasil) has received U.S. FDA approval for use in women between 9 and 26 years of age and confers immunity against HPV types 6, 11, 16, and 18. Initial trials with the vaccine have shown that the HPV-16/18 vaccine is safe and induces a high degree of protection against HPV-16/18 infection. Gardasil is given in three shots over six-months. The U.S. Centers for Disease Control and Prevention (CDC) recommends that girls 11-12 years of age receive the vaccine. It is also recommended for girls and women age 13 through 26 who have not yet been vaccinated or completed the vaccine series. |
