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By Scot Ackerman, M.D.

01/15/2019

Cervical Cancer Awareness Month

This New Year, Ackerman Cancer Center wants to promote health and wellness to all its patients and their families. It is important to be aware and conscious of your health and to take the necessary precautions for disease prevention, if possible. Being proactive in your well-being can lead to a long and healthy life.

During the month of January, we bring awareness to cervical cancer. Unfortunately, all women are at risk for developing cervical cancer. However, there are factors that can increase a women’s risk, including: Human papillomavirus (HPV) infection, immune system deficiency, chlamydia infection, diet that is low in fruits and vegetables, being overweight, long-term use of oral contraceptives, IUD use, having multiple full-term pregnancies, being younger than 17 in your first pregnancy, economic status, diethylstilbestrol (DES), and a family history of cervical cancer. Even with these risk factors, some women will never develop cervical cancer.

Cervical cancer used to be the leading cause of cancer death in women in the United States. Now, its incidence ranks 14th among other cancers. Since the introduction of the Pap smear test in the 1940s, the incidence of cervical cancer has dramatically declined by more than 50% in the last 30 years, in part due to the increased use of cervical cancer screening – the Pap smear test. According to the American Cancer Society estimates for 2018, approximately 13,200 new cases of cervical cancer will be diagnosed and about 4,200 women will die from cervical cancer in the United States. However, with advances in vaccinations and technology, cervical cancer is treatable and preventable.

Screening

The Pap smear test is still the most used and widespread screening tool for cervical cancer. It is recommended that women, ages 21-65 be screened every 3 years (if a negative result) during their annual physical exam. The Pap smear test is able to detect cellular abnormalities and precancerous lesions with tissue samples from the cervix. In addition to the Pap smear test, it is also recommended an HPV test (co-testing) be conducted to detect the presence of the Human papillomavirus, which can cause cervical cancer. It is important for women to have these tests conducted in safeguarding against HPV and cervical cancer.

Vaccinations

Currently, the only vaccine to protect against HPV in the United States is Gardasil 9. Cervarix was discontinued in the United States back in 2016, due to lack of being able to compete with Gardasil 9. Each of the vaccines protect against HPV 16 and 18, which are two of the high-risk strains of HPV known to cause cervical cancer. An added benefit for the use of Gardasil 9 is the ability to protect against other strains of HPV, including types 6 and 11, which cause about 90% of genital warts. The FDA approved Gardasil 9 for use in females ages 9-26 for the prevention against, cervical, vaginal, vulvar, and anal cancer and genital warts. For males ages 9-26, it protects against genital warts and anal cancer. An update to the Gardasil 9 vaccine occurred in October 2018. The FDA has now approved Gardasil 9 to be used by women and men between the ages of 27-45.

Treatment

The treatment modalities for cervical cancer depend on different factors including, the stage of the cancer, other health problems of the patient, and patient preference of treatment. Treatment options include immunotherapy, targeted therapy, chemotherapy, radiation, and surgery. Normally, patients use a mix of these treatment options. The most common form of treatment is surgery, in the form of a hysterectomy (complete removal of a woman’s uterus).

The treatment for cervical cancer has improved and is seen through the survival rate of women. According to Cancer.net, the 5-year survival rate is 67%. Survival rates also depend on the stage of the cancer and when it was diagnosed. When detected early, the 5-year survival rate is 92%. If the cervical cancer has spread to surrounding tissues and organs, the 5-year survival rate lowers to 57%. And, if the cervical cancer spreads to non-surrounding tissues and organs, the 5-year survival rate is only 17%. Looking at how these survival rates change shows the importance of the Pap smear test in being able to detect abnormalities in the cervix.

Through screening, vaccinations, and treatment, cervical cancer is a preventable disease. Pap smears play an important role in early detection and prevention of cervical cancer. Please encourage the women in your life to be screened whether it is annually or every three years. Stay proactive in your health and wellness and you will see the results!

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