Learning About Cervical Cancer
- Cervical cancer, which has been linked to the human papillomavirus (HPV), is curable when discovered early through routine screening, which is done through Pap Smears or HPV tests. However, two experts with Harvard Health Publishing revealed a recent study’s findings – saying there’s a rise in late-stage cervical cancer cases, are unsettling, especially since only 17% of women with later-stage cervical cancer survive five years or longer.
- According to the National Cancer Institute (NCI), cervical cancer forms in the cells of the cervix, the lower, narrow end of the uterus (womb) which connected the uterus to the vagina.
- Cervical cancer has also been linked to the human papillomavirus (HPV), an STI. And while it’s true that nearly all cases of cervical cancer are caused by HPV, people should also be aware that HPV puts both men and women at risk of developing several other cancers as well including cancers of the vagina, penis, anus and throat.
The study, titled, “The increasing incidence of stage IV cervical cancer in the USA: what factors are related?” ultimately researched distant stage cervical cancer in the U.S. and identified possible factors related to these trends with the help of cervical cancer data sent in to the United States Cancer Statistics program from 2001 to 2018, and national survey findings on Pap screening and HPV vaccination, Harvard Health Publishing reports.
Read MoreThe study found that new late-stage diagnoses increased 1.3% each year during the study. It also found that souther white women, between ages 40 to 44 saw a 4.5% increase in late-stage cases. Meanwhile, souther black women, between ages 55 and 59 were diagnosed twice as often as white women, for both early or late-stage cervical cancer.
Expert Cervical Cancer Information
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- HPV Vaccination Dramatically Reduces Cervical Cancer Rates; Everything You Should Know About The Vaccine
- New Hope for Patients With Cervical Cancer: Adding Immunotherapy Drug to Standard Chemo Treatment Could Improve Survival Time
As per the study, women living in the South are less likely to be screened for cervical cancer or vaccinated against HPV. However, this doesn’t provide a full reasoning for why there’s an increase in late-stage cases, Dr. Ursula Matulonis, chief of the Division of Gynecologic Oncology at Dana-Farber Cancer Institute, told Harvard Health Publishing.
Dr. Matulonis explained, “Most cervical cancer cases continue to be diagnosed early. These new findings suggest that cases involving a more aggressive cell type called adenocarcinoma are also increasing. Often found higher up in the cervical canal, this is harder to detect with a Pap smear.”
Meanwhile, Dr. Sarah Feldman, a gynecologic oncologist at Brigham and Women’s Hospital who also spoke with Harvard Health Publish, says older women diagnosed with cervical cancer may not have underwent the recommended number of screening tests with normal results before stopping testing.
However, in regard to the HPV vaccine, which is FDA-approved for females between ages 9 and 26, has led to a “pretty impressive” decrease in cervical cancer rates across race and ethnicities.
A journal shared by the American Cancer Society, found that “invasive cervical cancer rates among women 20 to 24 dropped by 3% each year from 1998 through 2012.”
Understanding Cervical Cancer
According to the National Cancer Institute (NCI), cervical cancer forms in the cells of the cervix, the lower, narrow end of the uterus (womb) which connected the uterus to the vagina.
“Cervical cancer usually develops slowly over time. Before cancer appears in the cervix, the cells of the cervix go through changes known as dysplasia, in which abnormal cells begin to appear in the cervical tissue,” the NCI explains.
“Over time, if not destroyed or removed, the abnormal cells may become cancer cells and start to grow and spread more deeply into the cervix and to surrounding areas.”
It’s important to know there are two main types of the disease, squamous cell carcinoma (up to 90% of cervical cancers) and adenocarcinoma.
Squamous cell carcinoma forms in the cells of the ectocervix (outer part of the cervix) and adenocarcinoma develops in the glandular cells of the endocervix (inner part of the cervix).
Cervical cancer is often difficult to detect as it doesn’t normally have symptoms until the disease has spread.
The NCI explains that symptoms of early-stage cervical cancer may include:
- vaginal bleeding after sex
- vaginal bleeding after menopause
- vaginal bleeding between periods or periods that are heavier or longer than normal
- vaginal discharge that is watery and has a strong odor or that contains blood
- pelvic pain or pain during sex
Symptoms of a advanced cervical cancer may include:
- difficult or painful bowel movements or bleeding from the rectum during bowel movements
- painful urination or blood in the urine
- dull backache
- swelling of the legs
- abdominal pain
- fatigue
“These symptoms may be caused by many conditions other than cervical cancer. The only way to know is to see a health professional. If it is cervical cancer, ignoring symptoms can delay treatment and make it less effective,” the NCI explains.
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The Importance of Pap Smears
Pap smears are one way to detect cervical cancer early. During the test, a doctor will collect a sample of cells from your cervix (using a small brush or spatula). The cells are then examined under a microscope for abnormalities, including cancer and changes that could indicate pre-cancer.
This is an important procedure because symptoms of cervical cancer might show up until the disease is at stage 3 or 4. By helping doctors catch signs of the disease early, Pap smears can lead to broader and more effective treatment options.
One of the leading causes of cervical cancer is the human papillomavirus (HPV), one of the most common viruses which can be transmitted through sexual contact. HPV is the biggest risk factor for cervical cancer, and there are usually no early signs or symptoms of the disease. However, cervical cancer can be detected through regular check-ups, such as pap smears.
According to the Centers for Disease Control and Prevention, it’s recommended that women start getting Pap tests at age 21. “If your Pap test result is normal, your doctor may tell you that you can wait three years until your next Pap test,” the CDC explains.
Meanwhile, anyone between 20 and 65 years old is urged to speak with their doctor on which testing option is best for them. The CDC explains, “An HPV test only. This is called primary HPV testing. If your result is normal, your doctor may tell you that you can wait five years until your next screening test.
“An HPV test along with the Pap test. This is called co-testing. If both of your results are normal, your doctor may tell you that you can wait five years until your next screening test. A Pap test only. If your result is normal, your doctor may tell you that you can wait three years until your next Pap test.”
For women older than age 65, the CDC says your doctor may suggest you don’t need further screenings if: “You have had at least three Pap tests or two HPV tests in the past 10 years, and the test results were normal or negative, and you have not had a cervical precancer in the past, or you have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids.”
What Is HPV?
Nearly every sexually-active person will get HPV at some point in their lives, but most people with the infection do not know they have it and never develop symptoms or health problems from it. The virus is spread via sexual activity and can manifest as warts on your genitals or mouth.
Get the Facts: HPV Can Cause Cancer in Men Too
When people talk about HPV and cancer risk, they tend to focus on cervical cancer. And while it’s true that nearly all cases of cervical cancer are caused by HPV, people should also be aware that HPV puts both men and women at risk of developing several other cancers as well including cancers of the vagina, penis, anus and throat.
Oral and throat cancers, for example, are both on the rise in young, non-smoking adults, and Dr. Allen S. Ho, an oncologist at Cedars-Sinai Medical Center, says HPV is the cause.
“The fastest-growing segment of the people developing oral cancers are young non-smokers, ” Dr. Ho told SurvivorNet in a previous interview. “HPV, a very common virus, one responsible for the vast majority of cervical cancers, is now identified as a cause of this rapid rise of oral cancers.”
Learning about the HPV Vaccines
Thankfully, we have three types of HPV vaccines – Gardasil 9, Gardasil and Cervarix. All three went through years of extensive safety testing before being approved by the U.S. Food and Drug Administration (FDA), and the CDC reports that HPV vaccination has the potential to prevent more than 90 percent of HPV-attributable cancers.
The HPV vaccines, like other immunizations that guard against viral infection, stimulate the body to produce antibodies that attack if they encounter the HPV infection by binding to the virus and preventing it from infecting cells.
The HPV vaccine prevents against certain cancers. It’s given to children which has created the misconception that it promotes sex at a young age.
HPV vaccines do not prevent other sexually transmitted diseases or treat existing HPV infections/HPV-caused disease, but their implementation can reduce the rates of certain cancers.
And while Dr. Susan Vadaparampil, the associate center director of community outreach, engagement and equity at Moffitt Cancer Center, previously told SurvivorNet there are few medical strategies that totally prevent against getting cancer in the first place, she emphasized that data from countries with high rates of vaccine coverages shows decreases in HPV-related pre-cancer and cancer, particularly so in the case of cervical cancer.
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“We have a safe and effective vaccine to prevent HPV-related cancer,” Dr. Vadaparampil told SurvivorNet. “It is widely available, and costs are typically covered by private or public insurance.”
Eileen Duffey-Lind, a pediatric nurse practitioner at Dana-Farber Cancer Institute/Boston Children’s Hospital, echoed Dr. Vadaparampil’s sentiment.
“No one should die of a preventable cancer like those tied to HPV, especially since we have a highly effective and safe vaccine available,” Duffey-Lind previously told SurvivorNet.
Who Should Get the HPV Vaccine?
According to the CDC, the HPV vaccine is recommended for all preteens (both girls and boys) 11 to 12 years old in two doses administered between six and 12 months apart. The series of shots can also be started as early as 9 years old.
That being said, the CDC also says that teens and young adults through age 26 who didn’t start or finish the HPV vaccine series also need the vaccine. And people with weakened immune systems or teens and young adults who start the series between the ages of 15 and 26 should get three doses instead of two.
Additionally, the HPV vaccine is sometimes administered in adults up to 45 years old, but it is not recommended for everyone older than 26. Still, a person older than 26 might decide to get vaccinated after talking to their doctor about possible benefits even though it is less effective in this age range since more people have already been exposed to HPV by this time.
Contributing: SurvivorNet Staff
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