Cancer of the cervix, the necklike opening that connects the uterus to the vagina, can take years to develop—an advantage since it allows ample time for early detection and treatment.
The cancer starts when cells in the cervical lining undergo abnormal changes. In 95 percent of cases, the changes result from exposure to the human papillomavirus (HPV), a sexually transmitted disease. Left untreated, these abnormal, or precancerous, cells may convert into cancerous cells. Fortunately, women have some powerful weapons against cervical cancer:
- Prevention Because sexual activity is a major factor in cervical cancer risk, avoiding sexual activity at an early age and being monogamous can protect women. And because smoking makes cervical cells more vulnerable to cancer, women who smoke should stop. A vaccine that protects against some cancer-causing HPV types has recently been approved by the U.S. Food and Drug Administration. The American Cancer Society (ACS) recommends vaccination for females ages 11 to 12, with “catch up” vaccination for those ages 13 to 18.
- Early detection Cervical cancer used to be among the most common causes of cancer death in American women. But thanks to the early detection afforded by Pap smears, the death rate from cervical cancer has dropped 74 percent since 1955.
That said, the need for regular Pap tests is clear—especially since in its earliest stages, the cancer has no symptoms. The ACS recommends all women have yearly Pap smears beginning at age 21 or when they begin having sex (women may have a Pap smear every two years if they’re using the newer liquid-based Pap test). The test continues to be necessary for women who have had hysterectomies or who are postmenopausal. Women older than 30 who have had three normal Pap results in a row may require the test less often, depending on their doctor’s recommendation.
Often, Pap smears identify precancers, the abnormal cells that could develop into cancer. In many cases, these abnormal cells, also called dysplasia, can be treated in the doctor’s office. The overwhelming majority of cervical cancer cases discovered by Pap smears are preinvasive (carcinoma in situ). That means the cancer is confined to the first layer of the cervical lining. Treatment for carcinoma in situ is very effective. And most of the time, invasive cervical cancers confined to the cervix can be successfully treated, usually with hysterectomy and/or radiation therapy.