Cervical cancer

Each year, about 12,000 women in the United States get cervical cancer. Cervical cancer happens most often in women 30 years or older, but all women are at risk.

Most cases of cervical cancer are caused by a high-risk type of HPV. HPV is a virus that is passed from person to person through genital contact, such as vaginal, anal, or oral sex. If the HPV infection does not go away on its own, it may cause cervical cancer over time.

Other things may increase the risk of developing cancer following a high-risk HPV infection. These other things include:

• Smoking
• Having HIV or reduced immunity
• Taking birth control pills for a long time (more than 5 years)
• Having given birth to three or more children

You may not notice any signs or symptoms of cervical cancer. Signs of advanced cervical cancer may include bleeding or discharge from the vagina. These symptoms may not be caused by cervical cancer, but the only way to be sure is to see your doctor.

Women should start getting screened at age 21. You can get a Pap test to look for changes in cervical cells that could become cancer­ous if not treated. If the Pap test finds major changes in the cells of the cervix, your doctor may suggest more tests to look for cancer. Women between the ages of 30 and 65 can also get an HPV test with your Pap test to see if you have HPV.

The Pap test and the HPV test look for different things.

A Pap test checks the cervix for abnormal cell changes that, if not found and treated, can lead to cervical cancer. Your doctor takes cells from your cervix to examine under a microscope. How often you need a Pap test depends on your age and health history. Talk with your doctor about what is best for you.

An HPV test looks for HPV on a woman’s cervix. Certain types of HPV can lead to cervical cancer. Your doctor will swab the cervix for cells. An HPV test is not the same as the HPV vaccine.

According to the U.S. Preventive Services Task Force (USPSTF), women ages 30 to 65 can combine the HPV test with a Pap test every 5 years. The USPSTF does not recommend the HPV test for women under age 30.

How often you need to be screened depends on your age and health history. Talk with your doctor about what is best for you. Most women can follow these guidelines:

• If you are between ages 21 and 29, you should get a Pap test every 3 years.
• If you are between ages 30 and 64, you should get a Pap test and HPV test together every 5 years or a Pap test alone every 3 years.
• If you are 65 or older, ask your doctor if you can stop having Pap tests.

If you had a hysterectomy, you should follow these guidelines:

• If you no longer have a cervix because you had a hysterectomy for reasons other than cancer, you do not need Pap tests.
• If you had a hysterectomy because of abnor­mal cervical cells or cervical cancer, you should have a yearly Pap test until you have three normal tests.
• If you had your uterus removed but you still have a cervix (this type of hysterectomy is not common), you need regular Pap tests until you are 65 and have had three normal Pap tests in a row with no abnormal results in the last 10 years.

You can lower your risk of getting cervical cancer with the following steps. The steps work best when used together. No single step can protect you from cervical cancer. The best ways to prevent cervical cancer include:

• Get an HPV vaccine (if you are 26 or younger). The HPV vaccine is recommended for girls who are 11 or 12 years old. But any girl or woman can get the HPV vaccine between 9 and 26 years. HPV vaccines are licensed, safe, and effective.
• Get regular Pap tests. Regular Pap tests help your doctor find and treat any changing cells before they turn into cancer. Women who have had the HPV vaccine still need to have regular Pap tests.
• Be monogamous. Being monogamous means that you only have sex with each other and no one else. The best way to prevent any sexually transmitted infection (STI), including HPV, is to not have vaginal, oral, or anal sex. But having sex with just one partner can lower your risk. That means that you only have sex with each other and no one else.
• Use condoms. Research shows that condoms can lower your risk of getting cervical cancer when used correctly and every time you have vaginal, anal, or oral sex. Protect yourself with a condom every time you have vaginal, anal, or oral sex.

HPV vaccines are approved for girls and young women from 9 through 26. Experts recommend that all girls get an HPV vaccine before any sexual activity, by the time they are 11 or 12. The Gardasil 9 HPV vaccine gives the most protection against cervical cancer for girls and women. Some girls younger than 15 may be able to get just two doses of the HPV vaccine, but others may need three doses of the HPV vaccine. The HPV vaccine is not recommended for pregnant women. Talk to your doctor to find out how many doses are best for you.

Yes. You can still benefit from the HPV vaccine if you have already had sexual contact before getting all three doses. This only applies if you have not been infected with the HPV types included in the vaccine.