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Cervical Cancer Risk Factors Screening and Symptoms

A risk factor is anything that changes your chance of getting a disease such as cancer. Different cancers have different risk factors. For example, exposing skin to strong sunlight is a risk factor for skin cancer. Smoking is a risk factor for many cancers. But having a risk factor, or even several, does not mean that you will get the disease.

The most important risk factor for cervical cancer is infection by the human papilloma virus (HPV)

Human papilloma virus infection is a sexually transmitted infection. According to the National Cancer Institute, research show that HPV-caused changes in the cervical cells happen slowly and often go away on their own, especially in younger women.

HPV is a group of more than 150 related viruses, some of which cause a type of growth called a papilloma, which are more commonly known as warts. Some types of HPV are called high-risk types because they are strongly linked to cancers, including cancer of the cervix, vulva, and vagina in women, penile cancer in men, and cancers of the anus, mouth, and throat in both men and women.

According to the National Institutes of Health, the 14 most cancer-causing HPV types are 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68. Women who test positive for types 16, 18, and 31 are the highest risk requiring colposcopy follow-up. After that, the next highest risk type of HPV is 45, 52, and 51. After that, it's 33 and 58 and then 56,66 and 59 and 35, 39 and 68.

It's important to keep in mind precancers have NO symptoms and NO visible lesions -- only advanced cervical cancers cause bleeding spontaneously or after sex.

Screening Guidelines

One of the most common and trustworthy tests used to detect precancerous and cancerous gynecologic conditions is the HPV test. All cervical cancer screening is HPV based. The old Pap test is no longer standard of care. When a woman is positive for HPV, cervical cytology can inform her risk of pre-cancer (CIN3) and cancer disease. At this time there is no cure for HPV. At this time the only treatment for pre-cancer disease is an office based surgical procedure, but the Rogel Cancer Center has a therapeutic drug in study so that women in the future will not have to have the surgical procedure.

All women should consider cervical cancer screening at age 21.

  1. For those women screening between the ages of 21 and 25, cytology is the only test available to them. If the cytology is normal, she repeats the screen in 3 years. If the cytology is abnormal, she is tested for HPV to determine her risk of CIN 3.
  2. Women between the ages of 25/30 and 65 should have a HPV test. If the test is negative, she can repeat her screening every 5 years. If the HPV test is positive she must have cytology to inform her risk of CIN 3. HPV testing is the preferred approach.
  3. Women over age 65 who have had regular screenings with normal results should not be screened for cervical cancer. Women who have been diagnosed with CIN 3 or cervical cancer should continue to be screened every 5 years, unless currently infected with HPV.
  4. Women who have had their uterus and cervix removed in a hysterectomy should not be screened.
  5. Women who have had the HPV vaccine should still follow the screening recommendations for their age group.
  6. Women who are at high risk for cervical cancer may need to be screened more often. Women at high risk might include those with HIV infection, organ transplant, or exposure to the drug DES or on immunosuppressive drugs. They should talk with their doctor or nurse.

Talk to your doctor about how and when you should be screened for cervical cancer.