Gynecologic cancers include any cancer that starts in a woman's reproductive organs. There are five main types: cervical, ovarian, uterine, vaginal, and vulvar. According to the American Cancer Society, more than 110,000 women in the U.S. are diagnosed with gynecologic cancers each year, and 13,000 of those will be cervical cancer.
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What is Cervical Cancer?
Cervical cancer occurs in the cells of the cervix, or the lower, narrow part of the uterus that connects to the vagina. Cervical cancer starts when healthy cells in the cervix develop changes in their DNA, and the mutations lead to rapid cell growth and the accumulation of abnormal cells that form a mass or tumor. While the exact cause of the cell changes isn't clear, it's certain that HPV (human papillomavirus) plays a role in virtually all cases.
HPV infections are the most common sexually transmitted infections in the U.S and the Centers for Disease Control and Prevention (CDC) estimates that more than 90% of sexually active men and 80% of sexually active women will have at least one type of HPV infection at some point in their lives. Most of the time, the infections will go away on their own without causing serious or long-term complications. However, in some cases, the virus survives for years, and can cause abnormal cells to mutate and develop into cervical cancer.
HPV is very common, but having a high number of sexual partners, starting sexual activity at an early age, not using condoms, or having other sexually transmitted infections (STIs) all increase your risk of acquiring HPV. Fortunately, highly effective and safe vaccines have been available for more than 15 years, and studies have shown the vaccine prevents the HPV types that cause 90% of all cervical cancer cases. The recommended age for vaccination is 11 or 12 years old – prior to becoming sexually active. However, the vaccine is still beneficial for those who are already sexually active as it's unlikely they've been exposed to all types of HPV covered. The vaccine recommended for those up to age 26, so talk to your doctor to see if you (or your daughter or another loved one) should be vaccinated.
While the HPV vaccine has significantly reduced the incidence of cervical cancer diagnosis and deaths, there are other factors that may also increase your risk including:
- A weakened immune system.
- Smoking. Smoking is associated with squamous cell cervical cancer.
- Exposure to miscarriage prevention drugs. If your mother took a drug called diethylstilbestrol (DES) while pregnant in the 1950s, you may have an increased risk of a certain type of cervical cancer called clear cell adenocarcinoma.
There are seldom signs of cervical cancer in the early stages. As it becomes more advanced, symptoms may include bleeding after intercourse, between periods, or after menopause; pelvic pain during intercourse, or unusual vaginal discharge.
The lack of early symptoms means it's even more important to get regular screenings to detect abnormal cells or changes before cervical cancer develops. An annual pelvic exam and Pap test can help discover many cervical conditions before they become more serious. During a Pap test a sample of cervical cells is collected and evaluated for any changes or abnormal growth. If abnormal cells are detected, there are several ways to test for cancer. If a test reveals you have cervical cancer, treatment options depend on the initial staging and extent of disease at diagnosis. Learn more about diagnosis and treatment options at El Camino Health.
With vaccination and regular screening, cervical cancer can usually be prevented – or at the very least detected during the earliest stage when it is most treatable. For most women, an annual pelvic exam and Pap test should be part of their routine care from ages 18 until at least 65. Talk to your doctor to ensure you are getting the regular screenings you need to help protect you against cervical cancer.
This article first appeared in the February 2023 edition of the HealthPerks newsletter.
