“The key is early detection of abnormal cells and the presence of human papilloma virus (HPV),” says Shyama Mathews, MD, a board certified gynecologist and a minimally invasive gynecologic surgeon on the Medical Staff of Penn Medicine Princeton Health. “In general, cervical cancer is a slow-progressing disease, so it can be treated successfully when caught early.”
Screening Recommendations Vary
Pap tests to screen for cervical cancer should begin at the age of 21. At age 65, women who have had recent testing and normal test results over the past 10-year period, who do not have a compromised immune system, and who do not have new HPV exposure or a history of cervical procedures in the past may be able to stop Pap tests. If you had a hysterectomy but still have your cervix, or had surgery due to pre-cancerous changes in the cervix, you still need regular screening.
The specifics of how frequently a woman should be tested varies depending on several factors, including age and whether she had an abnormal test in the past. The best advice is to see your gynecologist annually for an exam, and follow their recommendations for when you should have a Pap test. On average, it will be every 3-5 years.
While completing the Pap test, gynecologists also perform an HPV test to determine if the human papillomavirus is present. The virus is known to cause most cases of cervical cancer, and can be prevented with a vaccine. The recommendation is that both boys and girls be vaccinated against HPV around the age of 11 or 12.
“The vaccine is given by your family doctor or pediatrician, and ideally should be administered before a child becomes sexually active, since that is how HPV is transmitted,” says Dr. Mathews. “It can be received up to the age of 45, so gynecologists can also administer the vaccine, which protects against the nine most common strains of high-risk HPV.”
Treatment Can Vary
If a screening Pap with HPV testing detects an abnormality, then a closer inspection and biopsy of the cervix is done in the office. Depending on the results (mild vs. severe precancerous cells), the patient will either be advised to have Pap and HPV testing more frequently or a minor procedure can be done on the cervix to treat the abnormal cells. Fortunately, under medical supervision, 50% of HPV infections clear within one to two years, and up to 80-90% will resolve within two to five years.
“If cervical cancer is detected, treatment generally involves a combination of surgery, radiation, and chemotherapy. Additionally, some women may be candidates for immunotherapy treatment, which helps the immune system fight cancer,” says Charlotte Marcus, MD, who is board certified in obstetrics and gynecology and gynecologic oncology. “For women of childbearing age who still wish to have children, fertility sparing treatment approaches may be an option.”