Understanding cervical cancer, how to prevent it, and how to detect it early can help women avoid and address the disease before it develops or progresses. Screening for cervical cancer using the Pap test has helped decrease mortality from this cancer by more than 50%—but unfortunately, screening rates have also decreased in recent years.1 Know about the prevention and early detection of human papillomavirus (HPV) and cervical cancer to further the fight against the disease.
Human papillomavirus (HPV)
HPV is a sexually transmitted infection (STI) diagnosed approximately 14 million times a year.1 Most HPV infections will clear up on their own; however, persistent infections can cause serious health problems, including cervical cancer.1 Cervical cancer is associated with HPV in about 99% of cases.1 The most common types of HPV (out of more than 100 types) are HPV 16 and HPV 18, which lead to around 70% of cervical cancers.1
HPV prevention
To prevent HPV infections, all people should get an HPV vaccine starting from age 9 through age 45.2 The currently available FDA-approved HPV vaccines include:
- Gardasil 9,2 which protects against high-risk HPVs and cervical, vulvar, and vaginal cancers
- Cervarix,3 which protects against HPV 16 and HPV 18
Importantly, all individuals should uphold safe sex practices, including using barrier protection, to reduce the risk of HPV infection as well as other STIs.
Pap tests and HPV screening
To detect cervical cancer, women should start screening at age 25 with a primary HPV test every five years. If primary HPV testing isn’t available, women should get screened with either a:4
- Co-test that combines an HPV test with a Pap test every five years
- Pap test alone every three years
Women who don’t need to undergo screening include:4
- Those older than 65 who have had 10 years of normal screening results and no history of cervical precancer or more serious disease within the past 25 years
- Those who have undergone a total hysterectomy (with cervix removal), unless it was a treatment for cervical cancer or serious precancer
Cancer health discrepancies
Lesbian and bisexual women may be at a higher risk of cervical cancer because they appear to be less likely to routinely undergo screening. In fact, one study showed that about 30% of young lesbian and bisexual women hadn’t received a recent Pap test, when 70% of all women have received one within the previous three years.5
Possible reasons that lesbian and bisexual women aren’t pursuing screening are because they may have:
- Not received LGBTQI-tailored cancer content that offers information and guidance6
- Experienced negative interactions with their healthcare providers1
- Developed a fear of discrimination from healthcare providers1
Through education for all individuals, we can help increase screening rates for early cervical cancer detection and treatment.
Symptom-free cervical cancer
Women need to consistently undergo screening tests and pelvic exams to detect cervical cancer early, even if they aren’t experiencing any symptoms.4 If symptoms do occur, these might include pain or discomfort, or abnormal bleeding, such as bleeding that occurs between periods or after menopause.7 All women should seek medical attention if their body doesn’t feel right to them.1
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References
1 Benford D. 5 things to know about cervical cancer. City of Hope Breakthrough Blog. https://www.cityofhope.org/breakthroughs/what-you-need-to-know-about-cervical-cancer. Published January 11, 2021. Accessed December 20, 2021.
2 FDA approves expanded use of Gardasil 9 to include individuals 27 through 45 years old [news release]. Silver Spring, MD: U.S. Food & Drug Administration; October 5, 2018. https://www.fda.gov/news-events/press-announcements/fda-approves-expanded-use-gardasil-9-include-individuals-27-through-45-years-old
3 U.S. Food & Drug Administration. Cervarix. FDA.gov. https://www.fda.gov/vaccines-blood-biologics/vaccines/cervarix. Published October 25, 2019. Accessed February 4, 2022.
4 The American Cancer Society Guidelines for the prevention and early detection of cervical cancer. American Cancer Society Web site. https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/cervical-cancer-screening-guidelines.html. Updated April 22, 2021. Accessed December 16, 2021.
5 Reiter PL, McRee A-L. Cervical cancer screening (Pap testing) behaviours and acceptability of human papillomavirus self-testing among lesbian and bisexual women aged 21–26 years in the USA. J Fam Plann Reprod Health Care. 2015;41(4):259-264.
6 Vuong Z. Study suggests cancer care inadequate for LGBTQI+ Latinx population. City of Hope Breakthrough Blog. https://www.cityofhope.org/breakthroughs/study-suggests-cancer-care-inadequate-for-lgbtqi-latinx-people. Published September 20, 2019. Accessed February 9, 2021.
7 What is cervical cancer? City of Hope Web site. https://www.cityofhope.org/clinical-program/cervical-cancer/cervical-cancer-facts. Accessed February 7, 2022.