Cervical Cancer Awareness Month is the perfect time to remember that even small preventive steps can help protect our health. Each year in the United States, about 13,000 to 13,500 people are diagnosed with invasive cervical cancer. The good news is that cervical cancer is one of the most preventable and treatable cancers when it’s found early. HPV vaccination and regular screening play a powerful role in prevention and can help save lives.
Leading cervical cancer expert Rebecca Perkins, MD, gynecologist at Tufts Medical Center and Professor of Obstetrics and Gynecology at Tufts University School of Medicine, offers the latest guidance on preventing and detecting cervical cancer.
Understanding cervical cancer
What is cervical cancer?
Cervical cancer is cancer that starts in the cervix—the lower part of the uterus (womb) that connects to the vagina.
What are the signs and symptoms of cervical cancer?
In the earliest stages, most women will have no symptoms. In later stages, symptoms may include:
- Abnormal vaginal bleeding
- Unusual vaginal discharge
- Pain or bleeding during sex
- Pelvic pain
- Leg pain or swelling
What causes cervical cancer?
The CDC estimates that nearly all cervical cancers are caused by HPV (human papillomavirus), a very common virus that over 80% of people are exposed to during their lives.
If HPV is so common, why doesn't everyone get cervical cancer?
Good question! Most people's immune systems control HPV on their own. However, when the virus doesn't go away, it can cause abnormal cell changes over 5–10 years. If these changes aren't caught and treated, they can develop into cancer.
Is cervical cancer preventable?
Yes! Cervical cancer is one of the most preventable cancers. With the HPV vaccine and regular screening, more than 90% of cases can be prevented.
Can cervical cancer be treated successfully?
Absolutely. When caught early through screening, cervical cancer is highly treatable. If you’re diagnosed with cervical cancer, you’ll be referred to a gynecologic oncologist who specializes in treating gynecological cancers. Your doctor will work with you on a treatment plan, which may include surgery to remove tumors, radiation, chemotherapy or immunotherapy.
HPV vaccination
Who should get the HPV vaccine?
The HPV vaccine is recommended for boys and girls aged 9–12, and almost no cervical cancers have been found among those who were vaccinated as adolescents. Unvaccinated adults may still benefit up to age 45. Talk to your doctor about whether the vaccine is right for you or your family members.
How does the HPV vaccine prevent cervical cancer?
The vaccine protects you from the HPV strains most likely to cause cervical cancer. Studies show that the vaccine prevents infections, abnormal cells, and cancers among those who were vaccinated as adolescents.
Screening guidelines in the United States
When should I start getting screened for cervical cancer?
Screening should begin at age 21–25 regardless of when you became sexually active.
How do I get screened for cervical cancer?
There are two ways to screen for cervical cancer: HPV testing and Pap testing. HPV testing can be collected by your doctor during a speculum exam, or you can collect it yourself using a swab of the vagina. During a Pap test (also known as a Pap smear), your doctor uses a speculum to see the cervix and then takes a sample of cells from your cervix with a small brush. The cells are then tested for abnormalities that indicate cancer or precancerous changes that need further investigation.
How often should I get screened?
How often you should be tested depends on your risk level and medical history, but the following guidelines apply for those with an average risk:
- 21–24 years old: A Pap test alone is recommended.
- 25–29 years old: Either a Pap or HPV test is recommended.
- 30–65 years old: HPV testing is the preferred method of screening. Sometimes your clinician will perform an HPV test and a Pap test together.
- Over 65: You may stop having HPV tests if you have had regular, normal results and negative HPV tests at ages 60 and 65.
Remember that screening guidelines evolve as we learn more about the disease. People who have tested positive for HPV in the past, or who have conditions or take medications that lower their immune system, need to screen more often. Talk to your doctor about what is right for you.
What’s the difference between a Pap test and an HPV test?
- Pap test: Looks for abnormal cells in your cervix
- HPV test: Checks if you have the virus that causes cervical cancer
Both are effective screening methods, but HPV testing is preferred for women age 30 and older.
I’ve heard that there are new “self-collection” HPV tests now available. Is this a viable option?
Yes. Self-collection tests are now recommended by the American Cancer Society and the Women’s Preventive Services Initiative.
What does "self-collection" mean?
You can now collect your own vaginal sample for HPV testing using a simple swab. Your doctor will order the test for you, and you can collect it in the office or in the lab. There may be an option to collect it at home as well.
How does self-collection testing work?
- You receive a collection kit from your provider
- You use a swab to collect a sample from your vagina
- The sample is sent to a lab for testing
- You receive your results from your provider
- Your provider arranges any follow-up testing if the HPV test is positive
Who can use self-collection HPV testing?
Talk to your healthcare provider to see if you're eligible for self-collection. It's an option for primary HPV screening but may not be appropriate for everyone.
Why is self-collection testing important?
Many people skip screening because they:
- Feel uncomfortable with speculum exams
- Have difficulty getting appointments
- Have a primary care provider who does not perform speculum exams
- Have too many other concerns to discuss with their healthcare provider
Self-collection testing removes these barriers and makes it easier for everyone to get screened.
Will my insurance cover self-collection HPV tests?
Yes! In the United States, new policies require all insurance plans to cover self-swab HPV tests without any out-of-pocket costs.
Why screening matters
Why is cervical cancer screening so important?
Screening can find problems before they become cancer. Early detection means:
- Easier treatment
- Better outcomes
- Prevention of cancer development
What happens if screening shows abnormal results?
Your doctor will discuss next steps with you. Often, abnormal results mean additional testing or monitoring. Many cell changes go away on their own, and nearly all abnormal cells can be treated before they become cancer.
I feel healthy. Do I still need to get screened?
Yes! Cervical cancer often has no symptoms in early stages. Screening catches problems before you feel sick, when treatment is most effective.
Take action
What should I do now?
- Make sure every adolescent in your life receives the HPV vaccine
- Get screened according to the recommended schedule for your age
- Talk to your doctor about which screening method is best for you
- Ask about self-collection testing if speculum exams are difficult for you
Remember: prevention is the best medicine. Regular screening and vaccination can help make cervical cancer a disease of the past.
Key takeaways
- Cervical cancer is caused by HPV
- HPV vaccination in adolescence prevents cancer
- Regular screening catches problems early
- You can now test yourself without needing a speculum exam
- Most insurance covers testing for free
- Early detection saves lives
- Cervical cancer is largely preventable and treatable
