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Cervical Cancer Screening, HPV, and Diagnosis

HPV and Risk Factors

Human papillomavirus (HPV) can cause several types of cancer, including cervical cancer. It is important to understand how this common sexually transmitted infection (STI) may lead to a cancer diagnosis.

There are over 200 types, or strains, of HPV, some of which are spread through direct sexual contact. The strains can be divided into two categories of HPV:

Nearly all sexually active people are infected with HPV at some point during their lifetime. This is normal. Although about half of these infections are with a high-risk HPV type, most infections do not lead to cancer because the immune system is usually able to fight them off.

How does HPV cause cancer?

Sometimes the immune system is unable to fight off an HPV infection. When a high-risk HPV infection is persistent (does not go away over time), it can lead to cell changes (dysplasia) that, if left untreated, may develop into cancer. It takes about 10-20 years (or longer) for HPV-infected cervical cells to develop into cancer.

There are risk factors for HPV persistence and the development of cervical cancer, which include:

Aside from cervical cancer, HPV can also lead to other types of cancer such as vaginal, vulvar, penile, anal, and oropharyngeal.

While HPV is the most common cause of cervical cancer, it is important to note that another cause of cervical cancer (though much more rare) is exposure to diethylstilbestrol (DES) in utero. DES is a synthetic form of the female hormone estrogen. There are some other rare types of cervical cancer that are not due to HPV.

Several risk factors can increase the likelihood of developing cervical cancer. At the same time, many women with these risk factors do not develop the disease.

While HPV is the greatest risk factor for developing cervical cancer, other risk factors include:

Just because some of these risk factors may apply to you, does not mean you will get cervical cancer. It simply means you may be at a higher risk. The most important thing is to remain diligent with adhering to screening guidelines and to follow-up with your healthcare provider regarding any abnormal results or other concerns.

Screening and Prevention

When it comes to cervical cancer, the good news is that there are a few steps you can take to prevent the onset of HPV or catch any abnormal cells before they have the chance to progress.

HPV Vaccine

There is only one HPV vaccine used in the United States. The HPV vaccine protects against infection from nine HPV types, including the high-risk types that cause most HPV-related cancers, as well as those that cause the majority of genital warts. The vaccine is most effective when given between the ages of 9-12 (for both males and females), with eligibility up until 45 years of age. However, individuals between the ages of 27-45 should discuss with their doctor whether or not it is beneficial for them to get the vaccine. It is estimated that HPV vaccination prevents up to 90% of HPV-related cancers.

Since the HPV vaccine was approved in 2006, cervical cancer cases have steadily declined in the United States. However, the rate of other HPV-related cancers without standardized screening guidelines have increased during the same time period. As a result, research has shown that vaccination must be accompanied by routine screening in order to catch cancers early enough.

Pap Test

The Pap test (or Pap smear) is most commonly used to screen for cervical cancer. The Pap test consists of collecting cells from the cervix by using a cotton swab or soft brush. These cells are then viewed under a microscope to determine whether they are normal or abnormal.

HPV Test

The HPV test is used to detect the presence of cervical infection with high-risk HPV types that can cause abnormal cells. Like the Pap test, it involves the collection of cells from the cervix. The results will come back as either positive or negative for HPV.

What are the screening guidelines for cervical cancer?

However, you should always consult with your healthcare provider about whether or not you should continue to be screened for cervical cancer.

Symptoms

Although it is possible not to experience any symptoms, there are signs to be on the lookout for that could be an indication of cervical cancer.

Cervical cancer symptoms include:

Although these symptoms may be caused by factors other than cancer, it is important to be evaluated by a gynecologist. Listen to your body and know what is “normal” for you.

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