What's New in Cervical Cancer?

Many of us diligently have had our pap smears every year, sometimes for decades. But now our doctors’ recommendations are changing—why? What’s new?

One major change is that the new guidelines for screening and treatment now take into account personal risk for serious cervical disease. Another change is that there is now a vaccine available for young women and men to help reduce the incidence of cervical disease in women.

First, some background, cervical cancer is the third most common type of cancer in women worldwide. It usually develops very slowly through a precancerous condition called dysplasia. Dysplasia can be detected by a pap smear and is 100 percent treatable. Many (but not all) cervical cancers are caused by certain types of human papilloma virus, also know as HPV. HPV is a common virus that can be spread through close personal contact.

Early cervical cancer has no symptoms. More advanced disease may have symptoms that can include: abnormal vaginal bleeding between periods, after intercourse, or after menopause; continuous vaginal discharge, and periods that have become heavier and last longer than usual. Very advanced cervical cancer symptoms include back pain, fatigue, heavy vaginal bleeding, leg pain, loss of appetite, and weight loss.

Women can help reduce their risk of cervical cancer by having regular Pap smears—a test that is used to look at cervical cells to see if they are abnormal. If a patient has an abnormal Pap test result, her doctor may recommend further testing with colposcopy in the doctor's office.

So here is what’s new:

First, there is now a vaccine! This vaccine helps protect against four types of HPV that may lead to abnormal changes on your cervix. The vaccine is an injection into the upper arm and given in three doses at two months and six months after the initial injection. It is available to young females and males aged 9 to 26 years old. However, the vaccine is not 100% effective in preventing cervical cancer, and should not be looked on as an alternative to proper cervical testing with Pap smears.

Next, there are new guidelines based on each woman’s personal risk factors about when to start having pap smears, how often to have pap smears and when to stop.

It is now recommended that most women wait to start having pap smear screening until the age of 21. Meanwhile, most women without a history of abnormal pap smears who are between ages 21 and 29 should be screened every other year. Many women who are 30 and older may have Pap testing every 2 to 3 years, and if they are tested for HPV and this is also negative, they may be able to defer Pap testing for a little longer. When to stop pap testing? Some women older than 65 or 70 may be able to stop having Pap smears altogether.

Two things to keep in mind--these guidelines to do not apply to everyone, so you must speak to your Women’s Health Care Provider about your personal risk factors for cervical cancer, and whether you qualify for the new testing guidelines. Second, just because you may not need yearly Pap screening, it does not mean that you should miss your yearly check-up! There are many other parts of this visit that are important for your health.

To learn more about cervical cancer visit www.cancer.gov. To go along with today's health matters article, visit our Facebook page to learn more facts about the HPV vaccine.

Dr. Themarge Small is an OB/GYN at Southwestern Vermont Medical Center. To make an appointment with Dr. Small, call (802) 442-9600. Visit www.svhealthcare.org to learn more about SVMC. “Health Matters” is a weekly column meant to educate readers about their personal health, public health matters, and public policy as it affects health care.