According to the American Cancer Society, more than 11,000 women will be diagnosed with invasive cervical cancer this year in the United States. Of those, over 4,000 women will die from the disease.
But a new vaccine offers protection from the virus that causes most cases of cervical cancer. It is now recommended for some women.
Cervical cancer forms in the tissues of the cervix (the organ that connects the uterus and vagina). There are usually no symptoms until the cancer is well developed.
It is usually a slow-growing cancer, but one that can be detected with regular Pap tests.
"A Pap test is a procedure where a doctor scrapes cells from the cervix that a pathologist then views under a microscope," says Stephen Wells, MD, OB/GYN on staff at John Muir Health. "The test allows us an excellent opportunity to treat any changes that are precancerous before they become cancer."
Various strains of the human papillomavirus (HPV) are responsible for most cases of cervical cancer. HPV is a group of more than 100 viruses that may infect skin cells on the genitals, anus, mouth, or throat.
Papilloma viruses get their name from a type of growth called a papilloma. Papillomas are not cancer; they are warts that are associated with some types of HPV.
HPV is spread through sexual contact. And while roughly 20 million people in the U.S. are infected with HPV, most women with HPV infection do not go on to develop cervical cancer.
In 2006, the Federal Drug Administration (FDA) approved Gardasil, a vaccine that targets four strains of HPV and protects against genital warts. A new vaccine, Cervarix, is also available but does not protect against genital warts.
The Centers for Disease Control (CDC) recommend either vaccine. Both Gardasil and Cervarix protect against HPV strains that account for about 70 percent of all cervical cancers. Gardasil also protects against about 90 percent of genital warts.
Both vaccines essentially stop cervical cancer before it can develop.
The CDC recommends the vaccine for girls beginning at age 11 before they have become sexually active and potentially exposed to HPV. "The sooner the vaccine is given, the more immunity it provides," notes Babak Edraki, MD, gynecologic oncologist for John Muir Health.
"There are social taboos about sexually transmitted diseases and people tend to want to say 'not my daughter' but with a significant number of teens sexually active before they leave high school, this vaccine helps prevent unnecessary cancers and death," says Dr. Edraki.
The vaccine comes in a series of three separate shots over six months. It costs about $400, but insurance generally covers the expense.
"The cost is negligible compared to what this vaccine prevents," says Dr. Wells.
The CDC recommends the vaccination for girls and women up to age 27. Girls can get the vaccine as young as nine.
Some doctors suggest that women review their sexual history with their physician to see if the vaccine is appropriate for them. The more sexual partners one has, the more potential exposure to HPV, and thus a greater chance of developing cervical cancer.
"People tend to think that if they are in a monogamous relationship, that they don't need to worry about HPV," explains Dr. Wells. "But you can carry the virus for years before developing any abnormal changes or developing cancer. So, a stable relationship doesn't really mean you don't need the vaccine."
While the vaccine does provide protection for younger women who are not yet sexually active, there are some limitations. The vaccine doesn't target every type of HPV that can cause cervical cancer.
Because the vaccine is relatively new, it is still unknown whether the protection it provides is long lasting. And it does not stop a cervical cancer that is already developing at the time of vaccination.
Whether or not you elect to receive the vaccine for yourself or your daughter, there are some steps that you can take to help reduce the risk of developing the cervical cancer:
- Get an annual Pap test. "Routine screenings like Pap tests and pelvic exams are an essential part of good preventive health care and may help detect abnormal changes in the cervix," says Dr. Wells. Vaccination for HPV does not replace the need for routine Pap tests.
- Practice safe sex and use a condom.
- Limit your number of sexual partners. Your chance of an HPV exposure is increased with the more partners you have.
- Don't smoke. Smoking doubles the risk of cervical cancer.
"Anything that can reduce the incidence of cancer and spare a patient radical treatments, like radiation therapy or total hysterectomy, is a good thing," notes Dr. Edraki.
Dr. Wells agrees, adding, "This vaccine is an important part of health care for women and is a concrete step towards preventing cancer."