September was Cervical Cancer Awareness Month. Cervical cancer is the third most common cancer and cause of death among gynecologic cancers in the United States. According to the American Cancer Society, 13,170 women in the U.S. will be diagnosed with cervical cancer and 4,250 will lose their lives to the disease this year. It's important to talk about cervical cancer because it can be prevented with routine screening and vaccination protocols.

Here is some insight on cervical cancer risks, causes and prevention strategies.

Risks

The most important risk factor for cervical cancer is human papilloma virus (HPV) infection, which is very common among U.S. adults. In fact, the Centers for Disease Control and Prevention reports that 79 million Americans are currently infected with HPV and 14 million new cases are diagnosed per year.

The association between HPV and cervical cancer is so strong that other behavioral co-variables are found to be dependent upon HPV infection, meaning that most risk factors for cervical cancer are associated with variables that increase the risk of acquiring HPV or the inability to clear HPV infection.

Causes

The human papilloma virus is central to the development of cervical cancer. In fact, the virus can be detected in over 99 percent of cervical cancer cases.

While it is very common, not all women with HPV infection get cervical cancer. Most healthy adults can clear the HPV infection but for some (mostly people age 30 and older), the infection can become chronic and persistent, which is what can lead to abnormal Pap tests and, if untreated, can lead to cervical cancer. These factors have guided physicians in developing the current recommendations for cervical cancer screening.

Prevention

There are two central components to preventing cervical cancer: HPV vaccination and routine screenings with the Pap test.

The HPV vaccine has been approved by the U.S. Food and Drug Administration and shown to be effective at preventing HPV infection. In general, the HPV vaccine is recommended for girls and boys between ages 11 and 12 but is appropriate for patients as young as age 9 and up to age 26.

The recommendations are based on data showing that the vaccine is most effective if administered before a patient is exposed to HPV, and 50 percent of new HPV infections occur in ages 15 to 24. Being exposed to HPV infection is not a contraindication to get the vaccine; it is just most effective when given before HPV exposure.

If vaccination protocols are implemented appropriately, approximately 90 percent of invasive cervical cancer worldwide could be prevented, in addition to precancerous cervical lesions. Pediatricians, family physicians and gynecologists all play an important part in educating parents and patients about their roles in preventing cervical cancer in the future.

Screening tests, like the Pap test, can detect most precancerous cells in the cervix. If precancerous cells are found and removed early, cancer can often be prevented.

Unfortunately, up to 50 percent of women diagnosed with cervical cancer have never had a Pap test, and 10 percent have not had a Pap test in five years. If women had routine annual examinations and Pap testing, the rate of cervical cancer would decline.

The recommendations for routine screening tests can differ for each woman. In general, guidelines recommend Pap testing begin at age 21. Screening with a Pap is then performed every three years in women ages 21-29 and every five years for women ages 30-65. If the Pap or HPV test is abnormal, these recommendations change according to set protocols and follow-up algorithms. Therefore, it is important to schedule yearly gynecological exams, when cervical cancer screening is most often performed.

Even if your routine Pap tests are not recommended each year, it is important to still have an annual well-woman exam. This checkup includes additional exams critical to your health, such as a pelvic and breast exam; provides education regarding health maintenance; and the opportunity to talk with your doctor about any gynecological concerns you may have.

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