Seven things you didn’t know about cervical cancer screening and prevention

Shawn Davis-Wilensky, MD, MPH, FACOG, is a board-certified OB-GYN. She practices at Inova Saville Cancer Screening and Prevention Center.

Cervical cancer used to be among the most common cancer killers of women. But thanks to advances in prevention and screening, the general outlook has improved significantly. Here are seven things that may surprise you about cervical cancer screening and prevention.

1. Over 90% of cervical cancers are caused by a virus

Cervical cancer is one of the few cancers that is caused by a virus: human papilloma virus, or HPV. More importantly, it’s a virus that we already have a vaccine for. HPV is a common sextually transmitted infection, and although there are many subtypes of the HPV virus, the HPV vaccine covers the subtypes most related to invasive cervical cancer.

The HPV vaccine is very effective. Data collected on HPV infections among young women in the United States show that between 2006 (when the vaccine was approved by the U.S. Food and Drug Administration) and 2016, HPV infections decreased by 86% in girls ages 14 to 19 and by 71% among women in their early 20s.

2. The HPV vaccine is most effective when given to adolescents and young adults

It’s important to get the vaccine before a person is exposed to the virus:

• Generally, the optimal timeframe is for children to get the vaccine between the ages of 12 and 15
• Getting the vaccine by age 15 means a person only needs two shots – after age 15, a person needs three shots
• The vaccine is available for people as early as age 9 and can be given to people up to age 46, depending on the individual’s specific history
• HPV is not preventable by condom-use only
• Talk with your healthcare provider about whether you’re eligible to be vaccinated against HPV

3. Getting screened for cervical cancer is a great way to prevent it

Cervical cancer screening – such as getting regular pap smears as recommended by your healthcare provider – is very effective at catching abnormal, precancerous cells before they turn into cancer. If precancerous cells are identified, your provider will monitor them closely to ensure they heal and do not progress to cancer.

Many times, women can avoid invasive surgical procedures with careful monitoring. In short, for most women who are screened adequately, they will not progress to cervical cancer. The fastest growing group of women who have abnormal screening results are in the 25- to 30-year-old range, so don’t wait to start screening.

4. Women should expect to hear from their provider about their cervical cancer screening results

It’s important that women make sure they hear from their healthcare provider about their pap test results. People assume that if they don’t hear from their provider after the test, that means it’s normal – and this may not be the case.

There may be some “near normal” results that will require more frequent screening. Women need to know their specific test results, so they can follow up with their healthcare providers in a timely manner and make sure they don’t progress to cervical cancer. My advice is to make sure you connect with your provider to get your results, whether that’s by phone or through MyChart.

5. How often you need to screen for cervical cancer has changed

Cervical cancer screening is no longer needed every year:

• If you’re using pap tests to screen, you only need to test every three years
• If you have a pap test plus HPV testing, you only need screening every five years
• If you have HPV-only testing, you only need screening every five years
• If you have had a history of regular pap smears, you can stop getting them at age 65
• Your specific screening recommendations may be different depending on your individual medical history or the results of an earlier screening, so talk with your healthcare provider to see whether you need to screen more often

6. HPV-only testing offers important screening information

The American Cancer Society, the American College of Obstetricians and Gynecologists, and the U.S. Preventive Services Task Force all recommend HPV-only testing as a viable option for cervical cancer screening.

HPV-only testing enables women to find out if they have the type of HPV that could potentially lead to cervical cancer. In contrast, a pap smear can only show precancerous changes after they have begun. That means HPV testing can offer important information at an earlier point. Armed with that information, women and their healthcare providers can determine what further screening, if any, needs to happen based on their risk level.

If the HPV test is negative, your chances of getting cervical cancer in the next five years is almost zero.

7. New at-home cervical cancer screening could change the game

HPV-only self-sampling testing is on the horizon for women to screen for cervical cancer at home. Screening can start between ages 21 and 25. This test is only recently available in the U.S., so talk with your healthcare provider for specific advice. FDA approved self-collection at home is very limited as of right now, and a healthcare provider must still order the test. Self-collected HPV tests in a healthcare facility under the supervision of a healthcare provider who then sends in the test are available more widely. 

The test comes in a self-collect package. A soft cotton swab (similar to a Q-Tip) is inserted about two inches into the vagina and rotated. The test’s at-home version comes with packaging to mail it to the lab for screening, and the in-office version is mailed in by the healthcare provider.

This is a major breakthrough, particularly for women who have limited resources or don’t have access to pap testing through a healthcare provider. Being able to screen at home without needing an in-office visit with a provider is life changing.

Conclusion

My best advice about cervical cancer is that, in many cases, it’s preventable. So, get your HPV vaccine and follow up with regular screenings, whether HPV-only or pap testing. Even though your cervical cancer screening may only be once every three to five years, it’s still important to have an annual women’s health exam.

For the latest in cancer prevention, visit Inova Saville Cancer Screening and Prevention Center. To schedule a well-woman exam with an Inova provider, choose a convenient obstetrics and gynecology practice near you.