Cervical cancer is a significant health concern worldwide, despite advances in prevention and treatment. And while it’s less prevalent in the United States compared to other parts of the world, it continues to be a serious issue.
“Nationwide, we see 14,000 to 15,000 new diagnoses of cervical cancer a year in the United States, with somewhere between 4,000 and 5,000 women dying each year from it,” Dr. Joseph De La Garza said.
De La Garza, a gynecological oncologist at Methodist Hospital and Methodist Hospital | Landmark, said early screening and preventive measures are essential to combat the disease.
Globally, the situation is more severe, with approximately 500,000 new cases annually. This stark contrast underscores the role of advanced screening strategies to reduce the incidence of cervical cancer in the U.S.
“Cervical cancer is largely not common in the United States, thanks to our screening strategies, access to health care and Pap smears, but it is a real problem, and it does require attention so that we continue to be aware of it, screen for it and take care of women to prevent it,” De La Garza said.
The link between HPV and cervical cancer
According to De La Garza, human papillomavirus (HPV) is the primary cause of cervical cancer, with about 95% of cases associated with the virus. He said key risk factors include:
- Early age at first sexual exposure.
- Increased number of sexual partners.
- Smoking.
- Immunosuppressive conditions and immunotherapies.
- Chronic steroid use for conditions like psoriasis or gastrointestinal disorders.
It’s important to note that, unlike some other cancers, cervical cancer is not a genetic disorder.
“It’s a disease process that’s more associated with the elements of an infection and the ability for that infection to either be controlled and managed or allowed to persist and propagate.”
HPV’s role in cervical cancer development is critical to understand, as it highlights the magnitude of preventive measures like vaccination and regular screenings.
The importance of screening and vaccination
Screening for cervical cancer is imperative, as many women may not show symptoms until the disease is advanced.
“Screening should be offered to symptomatic and asymptomatic women,” De La Garza said. “Women who have risk factors or symptoms that could be considered concerning are irregular bleeding, bleeding following intercourse, pain with intercourse and irregular or abnormal vaginal discharge.”
While the symptoms mentioned might not be associated with cervical cancer at all, they could clue someone into the need for an exam.
The bottom line is that a Pap smear -- a test for detecting precancerous changes in cervical cells -- along with HPV testing, is pivotal in identifying potential issues before they progress to cancer.
“Start the conversation about screening and discuss prevention strategies with vaccination,” De La Garza said. “Make sure to implement screening on all women, no matter their race, color, religion, marital status, none of it -- there is universal screening for everyone.”
Additionally, HPV vaccination plays a crucial role in prevention. The vaccine is FDA-approved for individuals 9 to 46 years old and is effective in protecting against the nine most common strains of HPV infections that can lead to cervical cancer.
Despite the vaccine’s proven benefits, there are individuals still hesitant due to misconceptions about its safety and implications.
De La Garza acknowledged the fact that many parents have hesitations when it comes to the HPV vaccine but stressed that there is good data that demonstrates the vaccine is safe and effective at reducing the incidence of HPV and related cancers.
“There are different areas that HPV can create harm, and the vaccine protects against that. It is highly effective at reducing the incidence of HPV and abnormal Pap smears, or even the incidence of cervix cancer. It’s in line with being as safe and well tolerated as other vaccines.”
He said if anyone has specific concerns or questions about the vaccine, they should talk to their doctor, who should provide honest answers.
Addressing other common misconceptions and concerns
De La Garza said one common misconception the population seems to have is the belief that Pap smears and pelvic exams are the same.
“A Pap smear is a specific test that involves a swab or spatula to collect cells from the cervix to look for cancer,” he said. “A pelvic exam is a broader examination of the reproductive organs and does not include the Pap smear.”
The distinction is important for women to understand to ensure they are receiving the appropriate screenings.
“We’re still diagnosing a consistently low number of cervix cancers in young women (under the age of 21), so the guidance there is to perform a pelvic exam and provide screening for sexually transmitted infections. This means we don’t do Pap smears, but if we see something suspicious, we certainly biopsy it.”
For those who receive an abnormal Pap result, it’s important to remember that it does not necessarily mean cancer is present.
“An abnormal Pap smear is an opportunity to detect precancerous changes early,” De La Garza said, further explaining that most abnormal results do not indicate cancer but require further investigation to rule out or address any issues.
When women neglect regular screenings, it can lead to severe consequences.
“Persistent HPV infection is the leading cause of cervical cancer,” De La Garza said. “Women who have not had a Pap smear for at least five years or longer are at higher risk of developing cancer.”
Regular visits to a healthcare provider for screenings are essential in preventing the development of cervical cancer.
“Pap smears should be done in all women starting at age 21,” De La Garza said.
The future of cervical cancer treatment
When cervical cancer is diagnosed, treatment options vary based on the stage of the disease.
“Early-stage cancers are often treated with surgery, while more advanced cases may require chemotherapy and radiation,” De La Garza said. “Recent advancements include minimally invasive surgical techniques and the addition of immunotherapy to treatment regimens.”
Early screening and vaccination are pivotal in the fight against cervical cancer.
“Even after you’re done having children, or even after you’ve had a hysterectomy, women should still maintain routine women’s health evaluations,” he said. “Maintaining guideline-based screening and having a regular conversation allows you not to miss these things.”
De La Garza highlighted the need for continuous education and adherence to screening guidelines to reduce the incidence and impact of this disease.
“The most important thing is to start the conversation about prevention and ensure that all women are screened regularly according to guidelines,” he said.
By prioritizing regular screenings and vaccinations, individuals can significantly reduce their risk of cervical cancer and improve overall health outcomes.
To find a Methodist Healthcare specialist and schedule screening, click or tap here.