Cervical cancer is a gynecologic cancer forming in the cervix or the lower part of a woman’s uterus, and is primarily caused by human papillomavirus (HPV) infections. Cervical cancer was once a leading cause of cancer death in the United States, but both diagnoses and deaths have decreased significantly in past decades and have leveled off recently. However, cervical cancer remains the most common preventable cancer for women in underdeveloped countries.
During Cervical Health Awareness Month, Brandon Roane, M.D., a gynecologic oncologist at Texas Oncology–Methodist Charlton Cancer Center and Methodist Dallas Cancer Center Gynecologic Oncology, shares the importance of prevention and early detection of cervical cancer.
Who is most at risk for developing cervical cancer?
I think of cervical cancer as a disease most commonly seen in patients who have limited access to healthcare. Annual well-woman exams are effective at screening for and detecting early abnormalities that can become cervical cancer. Patients who are unable to get these routine check-ups, in my opinion, are the ones who have a higher risk for developing cervical cancer. There are a wide variety of reasons why women are unable to get routine check-ups, but it is up to us as healthcare providers to stress the importance of screening and pelvic exams as an effective way to prevent cervical cancer. Additionally, other behaviors can increase the risk of cervical cancer, such as smoking. Since cigarette use is typically associated with lung disease, most patients are surprised to hear that smoking is directly related to and significantly increases the risk of cancers of the female genital tract including cervical cancer.
There are a wide variety of reasons why women are unable to get routine check-ups, but it is up to us as healthcare providers to stress the importance of screening and pelvic exams as an effective way to prevent cervical cancer."
What can women do to reduce their risk of developing cervical cancer?
The most effective way to reduce the risk of developing cervical cancer is through the HPV vaccine. It is 100% effective at preventing cervical cancer from the two most common types of the HPV virus. This accounts for up to 75% of all cervical cancer cases worldwide. The key to optimizing the vaccine is to receive full vaccination prior to ever engaging in sexual intercourse. It is important to get adolescents vaccinated at a young age to essentially eliminate the risk of having cervical cancer at an older age.
When detected early, before the cancer spreads from the primary site, women have a 92% five-year survival rate of cervical cancer. What is the best way to detect cervical cancer in its early stages?
The best way to detect cervical cancer early is to see your primary care physician regularly for routine pap tests and exams. The cellular changes detected on pap tests can detect pre-cancer before it progresses into cervical cancer. This is the most effective way to diagnose at an early stage.
Early-stage cervical cancer is mostly a microscopic disease process. The cancer cells are present, but the tumor is so small, it is not visible on an exam. This is why pap tests are so important, because by the time the tumor has grown large enough to see on an exam, the prognosis has dropped significantly and treatment options are limited to more aggressive therapies.
Is there anything you wish more people knew about cervical cancer prevention, early detection, treatment, or survivorship?
In my opinion, cervical cancer is the most preventable gynecologic cancer, but it has the most profound impact on quality of life. Women who are undergoing treatment for cervical cancer usually require daily high dose radiation with weekly chemotherapy. This is usually followed by more radiation. The combination of these treatments and the disease can lead to significant side effects and impact quality of life. Cervical cancer can spread in a fashion that impairs kidney function, requiring tubes to be placed just to preserve the kidneys. Radiated disease can also lead to fistula formation, where there is a hole between the bladder and/or rectum and the vagina which leads to the inability to control bowel or bladder function. Many women live in significant amounts of pain even post-therapy. Early detection via pap tests and pelvic exams, not only improves prognosis and survivorship, but prevent cervical cancer from spreading to the point where it can have a lasting, significant impairment on quality of life.