Regular screening with a primary HPV test or a combination of an HPV test and a Pap smear can identify early precancerous changes, and treatment, when needed, can greatly reduce the chance that cervical cancer will develop or spread.
When it comes to cervical cancer, the importance of screening and vaccination cannot be overstated. According to the Centers for Disease Control and Prevention, up to 93% of cervical cancers are preventable.
Lifestyle
Some lifestyle habits can lower your risk of becoming infected with HPV, and may also reduce the chances of developing cervical cancer if you do become infected.
Sexual Partners
Having sex with multiple partners increases your risk of exposure to HPV and other sexually transmitted diseases. Having fewer partners may reduce your chances of getting the virus and spreading it to others.
Of course, it is possible to become infected with HPV even having only one partner, if your partner has been exposed to the virus by other partners.
Condom Use
Consistent and correct use of condoms can help prevent HPV infection. Because HPV is spread by skin-to-skin contact of the genital areas, condoms can reduce the chances of spreading infection by adding a barrier of protection. That said, condoms do not provide complete protection against HPV, because contact with the virus can still occur even with their use.
Smoking Cessation
Not smoking reduces the risk of developing cervical cancer, although smoking is not related to whether or not you will get the HPV virus. Smoking depletes your overall immune function, which normally helps you fight viruses such as HPV, as well as cancer. Women who smoke are about twice as likely as non-smokers to get cervical cancer.
Diet
Research shows that a healthy diet rich in fruits and vegetables, maintenance of a healthy weight, and regular physical activity can reduce the risk of cervical cancer. This is likely due to the fact that a healthy lifestyle optimizes immune system function and reduces the impact of cancer-promoting changes in the body.
Additionally, a research study from South America suggested that curcumin, a spice with antioxidant properties, may show promise in the inhibition of cervical cancer in a research setting. Antioxidants are naturally occurring substances that you can get from some types of foods (fruits and vegetables, in particular) that may help to counteract free radicals within your body that have been associated with the development of cancer. Although, more research is needed to confirm the benefits.
It’s also important to focus on getting antioxidants from whole foods instead of supplements, since clinical trials have found that antioxidant supplements often have little to no effect on cancer risk or mortality, and some may even increase the risk of cancer.
IUD Use
An intrauterine device (IUD) is a method of birth control that is placed in the uterus by a healthcare provider. The position of the device prevents pregnancy, and IUDs may contain spermicidal medication as well.
A systemic analysis of 16 research studies including 12,482 women concluded that cervical cancer was one-third less common in women who had IUDs. It is not completely clear why this effect occurs, but it is believed to be related to the immune system’s response to IUDs.
HPV Vaccination
There are a number of different strains of the HPV virus, and vaccination targets those that pose the greatest risk of cervical cancer.
Infection with HPV 16 and 18 represent around 70% of all cervical cancer cases, as well as high rates of anal, penile, and head and neck cancers. Another 20% of cases of cervical cancer are related to HPV 31, 33, 34, 45, 52, and 58. Additional HPV viruses that are associated with cervical cancer include HPV 35, 39, 51, 56, 59, 66, and 68.
The low-risk HPV strains HPV 6 and 11 do not typically cause cancer, but may lead to the development of genital warts.
Gardasil 9 is the vaccination option available in the United States; there are others available internationally. It protects against HPV 6, 11, 16, 18, 31, 33, 45, 52, and 58. The vaccine is given as a series of two or three shots over the course of six to 12 months. It is injected into the muscle of the thigh or upper arm and generally causes mild pain and discomfort.
In the past, two other vaccines were used: Gardasil and Cervarix. The original Gardasil vaccine provided protection for HPV 6, 11, 16, and 18; Cervarix only offered protection against HPV 16 and 18, but as noted, these strains account for around 70% of infections.
While it has been thought that HPV vaccination could reduce cervical cancer risk, a 2020 study provided evidence to back up that assumption. Swedish women and girls were given a quadrivalent vaccine (an HPV vaccine that protected against four of the strains above) and the incidence of cervical cancer was monitored.
Among those who received the vaccine prior to age 17, the incidence of cervical cancer was 88% lower than for those who were not vaccinated. Among women who were vaccinated later (between age 17 and 30, even if already sexually active), the incidence of the disease was 53% lower.
Check-Ups and Screening
If you experience any itching, bleeding, or discomfort of the vaginal area, be sure to report these problems to your healthcare provider. These can be early signs of HPV, cervical cancer, or another sexually transmitted disease or illness.
Of course, going for regular check-ups with your primary care healthcare provider and/or gynecologist is important even if you don’t have such symptoms. The fact that cervical cancer is currently the fourth most common cancer in women is a good enough reason to see your healthcare provider on a regular basis overall.
Screening
A Pap smear is a screening test that can detect the majority of cervical changes associated with the development of cancer, allowing for earlier treatment when success rates are higher. A primary HPV test is a test that checks specifically for high-risk types of HPV that are associated with cervical cancer.
Your healthcare provider will obtain a sample of tissue during a pelvic exam, using a small brush that scrapes the cervix. The test is mildly uncomfortable but does not require any anesthesia. This test may be done along with an HPV test, or an HPV test may be done alone (called primary HPV testing). You may experience mild bleeding for a few minutes up to a few hours, but you should not have persistent bleeding or pain.
The Pap sample is examined under a microscope to identify irregularities in the size, shape, and organization of cells of the cervix. Abnormalities that are not cancerous are often described as cervical dysplasia. Your HPV test will be reported as either positive or negative, and in the case of a positive, the specific strain may be noted. After your tests, your results may take up to a week to be sent to your healthcare provider.
According to 2020 guidelines, either an HPV test alone or a combination of an HPV test and a Pap smear is recommended every five years starting at the age of 25 and continuing until the age of 65 (as long as you don’t have any abnormal results). If you live in an area where HPV testing is unavailable, a Pap test every three years is an alternative. More frequent or early testing may be recommended if you have an abnormal screening test or have a medical condition that places you at higher risk.
Women Under the Age of 25
The age at initial screening was increased from age 21 to 25 in the 2020 guidelines. This is because HPV infections acquired in young women are more likely to resolve without causing cervical abnormalities, and screening those under 25 can lead to unnecessary treatments and side effects. In addition, many people are now protected by the vaccine.
That said, if you are younger than the age of 25 and sexually active, it is a good idea to schedule an exam with a gynecologist, family healthcare provider, or pediatrician. In addition to helping you decide if you need earlier screening, they can help you plan for either pregnancy or birth control, and if needed, do an evaluation for other STDs.
Follow-Up of Abnormal Results
If your HPV test is positive or if your Pap smear shows evidence of dysplasia, your healthcare provider may recommend further testing, such as a colposcopic exam, or at least more frequent follow up. Sometimes treatments to remove abnormal cells will be needed. For those who have been treated for significant dysplasia, screening will be recommended no more than every three years for at least 25 years.
A Word From Verywell
It can feel annoying to have to undergo regular pelvic exams and screening for cervical cancer, but it may be helpful to reframe these sometimes embarrassing visits in a different light. With appropriate screening and follow-up, cervical cancer is one of the most easily preventable cancers. And with one in three women expected to develop cancer during their lifetime, a little prevention may save a lot of heartache.
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