Cervical Cancer Facts from Inside Knowledge

Cervical Cancer Facts from Inside Knowledge

There are five main types of cancer that affect a woman’s reproductive organs: cervical, ovarian, uterine, vaginal, and vulvar. As a group, they are referred to as gynecologic (GY-neh-kuh-LAH-jik) cancer. (A sixth type of gynecologic cancer is the very rare fallopian tube cancer.) This fact sheet about cervical cancer is part of the Centers for Disease Control and Prevention’s (CDC) National Gynecologic Cancer Awareness Campaign. The campaign helps women get the facts about gynecologic cancer, providing important “inside knowledge” about their bodies and health.

What is cervical cancer?

Cancer is a disease in which cells in the body grow out of control. Cancer is always named for the part of the body where it starts, even if it spreads to other body parts later. When cancer starts in the cervix, it is called cervical cancer. The cervix is the lower, narrow end of the uterus. Also known as the womb, the uterus is where a baby grows when a woman is pregnant. The cervix connects the upper part of the uterus to the vagina (the birth canal).Cervical cancer is the easiest female cancer to prevent, with regular screening tests and follow-up. It also is highly curable when found and treated early.

Who gets cervical cancer?

All women are at risk for cervical cancer. It occurs most often in women over age 30. In 2005,* 11,999 women in the United States were told they had cervical cancer.

It is important to get tested for cervical cancer because 6 out of 10 cervical cancers occur in women who have never received a Pap test or have not been tested in the past five years. The human papillomavirus (HPV), a common virus that can be passed from one person to another during sex, is the main cause of cervical cancer. At least half of sexually active people will have HPV at some point in their lives.

Keep in mind, many people will have an HPV infection at some time n their lives, but few women will get cervical cancer.

Are there tests that can prevent cervical cancer or find it early?

There are two tests that can help prevent cervical cancer or find it early:

The Pap test is recommended for all women. Talk with your doctor, nurse, or other health care professional about whether the HPV test is right for you. Getting a Pap test regularly can find precancerous changes that can be treated, so that cervical cancer is prevented. And a Pap test can find cervical cancer early, when treatment is most effective.

When should I get tested for cervical cancer?

You should start getting regular Pap tests at age 21, or within three years of the fi rst time you have sex-whichever happens first. The Pap test is one of the most reliable and effective cancer screening tests available.

In addition to the Pap test-the main test for cervical cancer-the HPV test may be used for screening women aged 30 years and older, or at any age for those who have unclear Pap test results.

If you are 30 or older, and your screening tests are normal, your chance of getting cervical cancer in the next few years is very low. For that reason, your doctor may tell you that you will not need another screening test for up to three years. But you should still go to the doctor regularly for a check-up that may include a pelvic exam.

It also is important for you to continue getting a Pap test regularly-even if you think you are too old to have a child, or are not having sex anymore. If you are older than 65 and have had normal Pap test results for several years, or if you have had your cervix removed (during an operation called a hysterectomy), your doctor may tell you it is okay to stop getting regular Pap tests.

What raises a woman’s chance of getting cervical cancer?

Almost all cervical cancers are caused by HPV. You are more likely to get HPV if you started having sex at an early age, or if you or your partner have had sex with several others. However, any woman who has ever had sex is at risk for HPV. There are many types of HPV. Usually HPV will go away on its own, but if it does not, it may cause cervical cancer over time. Other things can increase your risk of cervical cancer. They include:

How can I prevent it?

What are the symptoms?

Early on, cervical cancer usually does not cause signs and symptoms. Advanced cervical cancer may cause bleeding or discharge from the vagina that is not normal for you, such as bleeding after sex. If you have any of these signs, talk to your doctor. They may be caused by something else, but the only way to know is to see your doctor.

What should I do if my doctor says I have cervical cancer?

If your doctor says that you have cervical cancer, ask to be referred to a gynecologic oncologist-a doctor who has been trained to treat cancers like this. This doctor will work with you to create a treatment plan.

Where can I find free or low-cost Pap tests?

If you have a low income, or do not have insurance, you may be able to get a free or low-cost Pap test through the National Breast and Cervical Cancer Early Detection Program. To learn more, call 1-800-CDC-INFO or visit www.cdc.gov/cancer/nbccedp.

Where can I find more information about cervical cancer?

Centers for Disease Control and Prevention: 1-800-CDC-INFO or http://www.cdc.gov/cancer
National Cancer Institute: 1-800-4-CANCER or http://www.cancer.gov

* HPV infection can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. While the effect of condoms in preventing HPV infection is unknown, condom use has been associated with a lower rate of cervical cancer.

Inside Knowledge is an initiative that supports the Gynecologic Cancer Education and Awareness Act of 2005, or Johanna’s Law, which was unanimously passed by the U.S. House and Senate (109th Congress) in December of 2006, and signed into law by President George W. Bush on January 12, 2007.

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Comments

"While the effect of condoms in preventing HPV infection is unknown, condom use has been associated with a lower rate of cervical cancer."

Actually there is a study that shows great protection from HPV is provided with sound condom use - 70% reduction in the transmission of HPV. When you consider cervical cancer is a small risk - 70% reduction in HPV is a great way of reducing the risk.

Condoms also protect against other STI's, an unwanted pregnancy and reduce the risk of urinary tract infections.

"No country has reported any decline in the incidence of or mortality from cervical cancer in women under 30, irrespective of screening. Many countries do not perform cervical screening in women under 30" Taken from "Cervical cancer screening" Australian Doctor, 2006 by Assoc Prof Margaret Davy and GP, Dr Shorne.

Your risk your health for no benefit having pap tests before 30 and even after that age, far more women are harmed than helped, so look at your risk profile and if you want to screen, adopt a program that provides some protection from the fairly high risk of false positives.

Also, what is with American women being tested from 21 even if they're not yet sexually active?

That is VERY concerning, risking their health for zero benefit - testing does not help women sexually active and under 30 and certainly not virgins of any age.
If your Dr suggest a pap test knowing you're a virgin or under 30 (and definitely 25), run!

Look at "Time to change the Policy" by Dr James Dickinson (on line) - when he sees your doctors recommend pap tests for all women from 21 (including women not yet sexually active) he assumes that's a guideline ignored in practice.

In other words, it makes no sense and risks your health - cervical cancer is a rare outcome after infection with HPV, a SEXUALLY transmitted infection. Don't panic though, HPV is common, cervical cancer is rare - almost all HPV clears after a year or two. It is only the rare cases that go onto cancer and something else is required - some suggest smoking, others an impaired immune system...the jury is still out on that one.

I don't understand what American doctors are doing - do they intend to destroy and damage healthy cervix after healthy cervix until few are left - this is insane, the cancer is rare! With no screening at all, only 1% (at most) would get cervical cancer in the States, 0.65% in Australia.

Also, the article mentioned (Davy & Shorne) shows that women not at risk (excluding virgins, only the States include virgins in their recommendations) will STILL be tested because the recommendations and programs are about populations and not individuals - this is unacceptable as it risks the health of low risk women (false positives) and puts them through an unpleasant (sometimes painful) invasive exam every 2 or so years. Demand that your individual risk profile is considered and satisfy yourself that screening is in YOUR best interests.

I don't screen at all, as a low risk woman I would be accepting high risks for no benefit.

"The pap test is one of the most reliable screening tests available"

You must be joking! The pap test is intrinsically unreliable - you say 6 out of 10 women who get cervical cancer haven't had pap tests, that also means just under half had pap tests! (4/10)

It's true a very small number of women are helped by pap tests, but many more women are harmed to some degree by this testing. Angela Raffle, UK expert tells us 1000 women need regular screening for 35 years to save ONE woman from cervical cancer. (cc) BMJ, 2003 (Commentary: "Why I'll never have another smear test" by Anna Saybourn - online)

Cervical cancer is rare, always was and was in decline before screening started...an UN-screened high risk woman has a 0.65% lifetime risk of cervical cancer, low risk women have even less risk.

The pap test produces lots of false positives and these can lead to unnecessary and harmful over-treatment. Damage to the cervix can cause infertility, miscarriages, high risk pregnancy, premature babies and psych issues. LEEP and cone biopsies carry the most risk to your body.
1 in 14 pap tests are "abnormal" in women over 25 and 1 in 3 for women under 25...almost all are false positives.

Annual screening is the worst - lots of harm for little additional benefit over 3 yearly screening - 95% of women will be referred after an "abnormal pap" with annual screening while 3 yearly sends 65% (2 yearly - 78%)

Women under 25 don't benefit from screening, it doesn't reduce the tiny death rate, but causes lots of over-treatment with false positives.
To reduce harm to healthy women the UK doesn't screen before 25 and the Netherlands and Finland, not before age 30. Finland has the lowest rates of cc in the world and sends the fewest women for colposcopy/biopsies (fewer false positives) and they offer 5 yearly screening from age 30.

As a low risk woman with a risk of cc near zero, I made an informed decision more than 20 years ago not to screen - the risks were too high for me. Sadly, I didn't get the information I needed from a Dr or the Health Dpt, instead I did my own research.

Informed consent is a legal and ethical requirement for all screening - I'd urge all women to assess their level of risk and if you choose to screen, protect yourself from early and over-screening. Dr Joel Sherman's medical privacy forum under womens' privacy issues has lots of great references that may assist you in your decision-making.

I'd recommend articles by Angela Raffle, UK screening expert and by Richard DeMay, American pathologist.

Be careful with well-woman exams as well, they are not evidence based and expose you to risk for doubtful benefit, our doctors do not recommend them in symptom-free women at any stage of life. Mammograms also carry risk - the Nordic Cochrane Institute have produced a rare, unbiased summary, "The risks and benefits of mammograms" - at their website.

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