The "Who, What and When" of Cervical Cancer

Known as the “silent killer”, cervical cancer is slow growing and often symptoms do not appear until the cancer becomes invasive. January is National Cervical Health Awareness month and an opportunity to learn more about screening tests to identify this highly preventable cancer. Nurses Announcements Archive

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January is National Cervical Health Awareness Month and a chance to raise awareness about cervical cancer prevention. This cancer is slow-growing, and you may not have any symptoms, making it “the silent killer”. About 13,000 new cases of cervical cancer in the U.S. will be diagnosed in 2019, although it is highly preventable because of current screenings and vaccines.

Who Gets Cervical Cancer?

All women are at risk for cervical cancer, but it most often occurs in women over age 30. The human papillomavirus (HPV) is the most common cause and the primary risk factor. Other risk factors that increase the risk of cervical cancer include:

  • Smoking
  • Having a weakened immune system
  • Chlamydia infection
  • Being overweight
  • IUD use
  • Multiple full-term pregnancies
  • First full-term pregnancy under the age of 17
  • Family history
  • Diet low in fruits and vegetables
  • Using birth control pills for 5 years or longer

What are the Symptoms?

Early cervical cancers usually do not have any presenting signs or symptoms. As the cancer becomes invasive and grows into nearby tissue, the most common symptoms include:

  • Abnormal lady partsl bleeding, such as bleeding after sex, bleeding after menopause, bleeding and spotting between periods and having periods that are longer or heavier than usual
  • Unusual discharge from the lady parts, which may contain blood and occur between your periods or after menopause
  • Pain during sex

Since these signs and symptoms occur with other gynecological disorders, it is important to seek healthcare for any of the above.

What Tests Prevent Cervical Cancer or Finds It Early?

Fortunately, cervical cancer is highly preventable and there are two tests that either prevent or provide early detection. Depending on your age, your doctor may recommend a Pap test (or smear), or an HPV test, or both tests together.

The PAP test is one of the most reliable cancer screening tests available. It screens for cervical cancer only and detects pre-cancers and cell changes on the cervix that can be treated so cancer is prevented. The HPV test looks for the HPV virus that can cause precancerous cell changes and cervical cancer. Let’s take a look at the testing guidelines, according to the CDC.

If You Are 21 to 29 Years Old

You should begin Pap testing at age 21. If your tests are normal, your doctor may tell you to wait and have your next Pap test in three years.

If You are 30 to 65 Years Old

Your doctor will determine the best testing option for you.

  • Pap test only. If results are normal, you may be told to wait three years before your next Pap test.
  • An HPV test only. This is called primary HPV testing. If your result is normal, you may be told to wait five years until your next screening.
  • An HPV test with the Pap test. This is called co-testing. If both results are normal, your doctor may tell you to wait five years until your next screening.

If You Are Older Than 65

You should continue Pap and HPV testing as your doctor recommends, even if:

  • You think you are too old to have a child
  • Not having sex

Your doctor may tell you that you don’t need to be screened anymore if:

  • Your screening test results have been normal for several years, or
  • Your cervix has been removed as part of a total hysterectomy for non-cancerous conditions (i.e. fibroids).

You can review a full version of cervical screening guidelines here.

What Are Recommendations for HPV Vaccination?

HPV is a group of more than 200 related viruses, with more than 40 being spread through direct sexual contact. There are around a dozen HPV types that can cause certain types of cancer, including cervical, anal, oropharyngeal, penile, vulvar and lady partsl.

Current CDC recommendations for vaccination are as follows:

  • Children and adults ages 9 – 26 years
  • Routinely recommended at age 11 or 12; can be started as early as 9 years of age
  • Recommended persons through age 26 who were not previously vaccinated
  • Adults ages 27 through 45 years of age

The vaccine is now recommended for all ages 27 through 45 years. Clinicians should discuss with patients in this age group who were not adequately vaccinated earlier if the HPV vaccination is an option for them. HPV vaccination may provide less benefit in this age group because more people have already been exposed to the virus.

If You Are Pregnant

HPV vaccination should be delayed until after pregnancy. But pregnancy testing is not required before vaccination since there is no evidence vaccination will affect pregnancy or harm a fetus.

For more information about HPV vaccination, visit the National Cancer Institute’s HPV vaccination website here.

Where Can I Find Free or Low-Cost Screening Tests?

People who have a low income or no health insurance may be able to get free or low-cost cervical cancer screening through the National Breast and Cervical Cancer Early Detection Program. To learn more, call 1-800-CDC-INFO or visit: CDC - Cancer.

As a nurse, you often have the opportunity to educate patients on what they can do to prevent cervical cancer. Education is a key prevention strategy, as cervical cancer is the easiest gynecological cancer to prevent and is highly curable when detected early.

Additional Information

American Cancer Society-Cervical Cancer Month

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