Dr. Ruchi Garg shares ways women can maintain good reproductive health
January was Cervical Health Awareness Month, and it is the perfect opportunity for women to visit their healthcare providers for an annual wellness exam that includes a cervical cancer screening. The cervix sits at the bottom of the uterus and protrudes into the vagina. Through sexual contact, the cervix can be exposed to one or more strains of the human papillomavirus (HPV), some of which present a high risk of causing most cervical cancer. Currently, 79 million Americans live with the HPV infection.
Each year, more than 13,000 women are diagnosed with cervical cancer, and almost 4,300 women die from it. Cervical cancer is often diagnosed in women over the age of 30.
Ruchi Garg, MD, is a board-certified gynecologic oncologist at Inova Schar Cancer Institute. In this Q&A, Dr. Garg provides answers to commonly asked questions about how often women should get a Pap smear, risk factors and early symptoms.
What is cervical cancer, and how often should women be screened for it?
Cervical cancer results when healthy cells of the cervix experience changes in their DNA after exposure to HPV. Other factors that could heighten a woman’s risk for cervical cancer include immune system deficiency, herpes or actively smoking.
“While there aren’t too many early symptoms of cervical cancer, screening tests like a Pap smear are the best way to help detect early signs of cancer cells and prevent them from spreading,” Dr. Garg says. “Not too long ago, it was recommended for women to receive a Pap smear every year. Now, it’s suggested that women between the ages of 21 to 30 get a Pap test once every three years. For women between 31 and 65, a Pap test is recommended every three or five years. At the five-year mark, a physician may order a Pap smear and an HPV test.”
What is HPV, and how is it transmitted?
HPV is a viral infection that can cause skin warts or even cancer. The infection is typically transmitted sexually or by skin-to-skin contact. Vaccines that can help protect against certain strains of the virus. An HPV test can detect if a woman has the virus, but not if cancer is present.
“When it comes to the role that HPV plays in cervical cancer, it’s quite possible for the virus not to turn into cancer,” Dr. Garg says. “For many women, HPV infections go away on their own, but there are certain strains of HPV — specifically numbers 16 and 18 — that can increase a woman’s cervical cancer risk.” If results from the Pap test are found to be abnormal, a cervical biopsy is performed to determine if there are precancerous cells or active cancer on the cervix.
The best way for women to prevent getting infected with HPV is to use a barrier device, such as a condom during sex, get vaccinated and not smoke. HPV vaccinations are typically administered to women and men between the ages of nine and 26, but the FDA approved in October 2018 that those ages 27–45 can receive the vaccine.
How is cervical cancer treated?
Once a diagnosis has been made, there are different treatment options that a physician can recommend, which include surgery, radiation and chemotherapy.
“Depending on the stage of a woman’s cancer, age and the location of the cancer cell growth, her physician will recommend an option that will ultimately be best for her overall health,” Dr. Garg says. “Once a treatment option is chosen, women diagnosed with cancer will receive treatment based on the stage of their cancer.”
With the enhancement of technology and the increased use of the Pap test, the cervical cancer death rate has decreased, but it hasn’t changed much over the last two decades.
“More than anything, it is important women over the age of 21 to speak candidly and annually with their doctor about their reproductive health,” Dr. Garg says.
Discuss cervical cancer screening recommendations with your doctor or find a gynecologist at Inova.