Cervical cancer is less deadly than it used to be, thanks to the advent of screening tools that catch cellular changes early. But still, far too many women suffer because of this largely preventable disease. This year, the American Cancer Society estimates, more than 14,000 women will be diagnosed with cervical cancer and more than 4,200 women will die from the disease.
The key to preventing this cancer is vaccination and regular screening, says UNC Health oncologist Oludamilola “Lola” Olajide, MD.
“Almost all cases of cervical cancer are caused by human papillomavirus (HPV) infection, which we have a vaccine for,” Dr. Olajide says. “Also, regular Pap test screening is vital for early detection.”
We asked Dr. Olajide to answer common questions about cervical cancer.
What causes cervical cancer?
The human papillomavirus (HPV) is the main cause of cervical cancer. Some strains of the virus may cause genital warts, and some are linked to cancers of the cervix, vulva and vagina. The virus is spread by skin-to-skin contact, usually through sexual activity. (HPV infection also can lead to cancers of the mouth, throat, anus and penis.)
“HPV infection is common among men and women,” Dr. Olajide says. “Usually, the body clears the infection by itself, but sometimes chronic infection in women can increase the risk of developing cancer.”
Nearly all sexually active men and women will get HPV at some point, according to the Centers for Disease Control and Prevention.
Who is at highest risk for developing cervical cancer?
Cervical cancer is most frequently diagnosed in women between ages 35 and 44. It rarely develops in women younger than 20. However, more than 20 percent of cases are found in women over age 65.
Hispanic and Black women are diagnosed with cervical cancer at higher rates than other races and ethnicities, followed by white women. American Indian and Alaska Native women and Asian and Pacific Islander women experience cervical cancer less commonly.
Women with lower incomes are more likely to die from cervical cancer, likely because they may not have easy access to adequate health care services, including Pap and HPV tests.
What are the greatest risk factors for getting cervical cancer?
Risk factors associated with HPV-related cancers include:
- Becoming sexually active at a young age. “Compared to women who first have intercourse at age 21 or older, the risk is 1.5 times greater to those who are 18 to 20 years old when they first have intercourse,” Dr. Olajide says. “The risk is two times greater for women who are younger than 18 when they first have intercourse.”
- Having multiple sex partners. “Compared with one partner,” she says, “the risk is approximately twice with two partners, and three times more likely with six or more partners.”
- Having a high-risk sexual partner (someone who has had multiple sex partners or a known HPV infection).
- Having a history of sexually transmitted infection, especially chlamydia and genital herpes.
- Being younger than age 20 when you have your first child or having three or more children.
- Immunosuppression (for example, due to HIV infection).
- “Regardless of your HPV status,” Dr. Olajide says, “cigarette smoking is associated with an increased risk of developing cervical cancer.”
Can cervical cancer be prevented?
One of the best ways to prevent cervical cancer is to receive the HPV vaccine in childhood, at 11 or 12 years old, Dr. Olajide says. The vaccine is given in two doses, six months apart and is recommended for both boys and girls. (If you missed that window, don’t despair—the vaccine can be given into middle age.)
“There is a latency period of 10 to 15 years between HPV exposure and cervical cancer development,” she says, “which is why it is so important for vaccines to be given before individuals become sexually active.”
Women should talk to their doctor about cervical cancer screening, such as Pap tests and HPV tests. These tests can be lifesaving early warnings of cancer to come.
“Screening for cervical cancer allows for detection and treatment of precancerous lesions before they progress to cervical cancer,” Dr. Olajide says. “Screening is also helpful to detect cervical cancer when it is present in the earliest stages and much easier to cure.”
How is cervical cancer treated?
Treatment of cervical cancer varies, depending on the stage of the disease and how far it has spread. For the earliest stages, surgery or radiation combined with chemotherapy may be used. For later stages, more aggressive radiation combined with chemotherapy is the primary treatment.
“Treating cervical cancer frequently involves several specialists, including gynecologic oncologists, radiation oncologists and medical oncologists,” Dr. Olajide says.
Is cervical cancer curable?
The ability to cure cervical cancer depends greatly on the state of the cancer when it is detected, Dr. Olajide says. More than 90 percent of cases of cervical cancer are cured when they are detected in the earliest stages, but the survival rate declines if the cancer spreads to other parts of the body.
“Prevention is better than a cure,” she says. “In addition to screening and HPV vaccination, women should not smoke, try to maintain a healthy weight, and eat plenty of fruits and vegetables. If cervical cancer is detected, maintaining these healthy habits will help you recover from treatment.”
If you have questions or want to be screened for cervical cancer, talk to your doctor, or find one near you.