Cervical Cancer Is Preventable: HPV Vaccines and Screening

Here’s the good news about cervical cancer: It’s 100 percent preventable. We have the vaccines and the screening technology to eliminate the risk of cervical cancer entirely. In fact, the World Health Organization (WHO) believes that with widespread HPV vaccination, regular screening and treatment of precancerous lesions, cervical cancer can be eliminated.

And yet, the rates among women are increasing. In fact, cervical cancer is the fourth most common cancer among women globally, according to WHO. In the United States, about 13,000 people are newly diagnosed with cervical cancer each year. To better understand how we can help women prevent cervical cancer, we spoke with Mark Borowsky, M.D., medical director for Gynecologic Oncology at Hackensack Meridian Health’s Jersey Shore University Medical Center.

How the HPV Vaccine Can Help Prevent Cervical Cancer

HPV, or human papillomavirus, is a very common sexually transmitted infection. There are more than 100 types of HPV, and most infections clear on their own without treatment. Many people never know they were infected. However, some high-risk types can lead to cancer over time. “It’s fair to say that almost all cervical cancers are caused by these HPV types,” says Dr. Borowsky.

This means that preventing HPV infection is the first step toward elimination. The HPV vaccine protects against nine types of HPV, including some of the high-risk strains— it is typically offered as part of routine childhood vaccinations at ages 11 or 12. The goal is for everyone to be protected before they become sexually active. Catch-up vaccination is recommended up to age 26 for anyone who didn’t get it earlier.

Research shows that infections with high-risk HPV types have decreased since the vaccine was introduced. Dr. Borowsky calls the HPV vaccine “the most important tool” for prevention. “When I first started practicing gynecologic oncology 25 years ago, I saw far more cervical cancer than I do today,” he says. Despite the success of the vaccine, Dr. Borowsky says he still sees a lot of patients who are unvaccinated.

How Cervical Cancer Screening Saves Lives

Screening is another key part of eliminating cervical cancer. There are two types of screening tests. 

HPV Tests 

HPV tests look for the virus itself. They can identify whether someone has the virus type(s) that cause most cervical cancers. A positive test does not mean a person has cancer or that they will get cancer in the future. It does mean that they should be monitored more closely.

Pap Tests

Pap tests look for abnormal changes to cervical cells. They can identify precancerous changes to cells on the cervix. Those changes can be treated before they become cancer. According to Dr. Borowsky, “We can prevent the vast majority of cervical cancers by identifying and treating precancerous lesions years in advance.”

Who Should Be Screened for Cervical Cancer 

The American College of Obstetricians and Gynecologists advises that cervical cancer screening should begin at age 21. Between age 21 and 29, anyone with a cervix should get a Pap test every three years. If your results are normal, your doctor may recommend waiting three years before your next Pap test.

People between ages 30 and 65 have several screening options:

• A Pap test every three years
• A Pap test and HPV test together every five years (called co-testing)
• An HPV test alone every five years

Most people can stop screening at 65, though the U.S. Preventive Services Task Force recommendations are currently being revised and may change soon. There are new recommendations from the American Cancer Society that are slightly different. Anyone who has questions should talk to their health care provider.

What Cervical Cancer Screening Involves

Cervical cancer screening is a simple procedure that is usually done by a gynecologist or nurse practitioner. They use a speculum to gently open the vagina and view the cervix. They then use a small brush or spatula to collect cervical cells, which are sent to a lab for either a Pap test, HPV testing or both. 

The U.S. Food and Drug Administration recently approved self-collection kits for HPV tests. This means that people can collect their own sample of cells without getting a speculum exam, though you may still need to see your provider as part of the screening process. Experts hope that self-collection will increase the number of people who are screened by making HPV tests easier to access.

Follow-Up Care Matters

Most people who are screened will likely have normal results, but some people will be told that they have high-risk HPV or abnormal cells on their cervix. When this happens, Dr. Borowsky advises, “They should not panic. They should get a follow-up.” 

Follow-up could be as simple as more frequent Pap tests. In some cases, it could require other slightly more invasive tests like colposcopies, biopsies and even surgery to remove the abnormal cells or lesions.

There are a lot of reasons for abnormal results that are not cancer or precancer, but they still require follow-up. “I could safely say that the vast, vast, vast majority of abnormalities are not invasive cervical cancer. But that doesn’t mean that they’re not significant or that they don’t require treatment,” Borowsky explains.

Next Steps & Resources:

• Meet our source: Mark Borowsky, M.D.
• Make an appointment online with a gynecologic oncologist or call 800-822-8905.
• Learn more about Hackensack Meridian Health’s gynecologic oncology services. 

The material provided through Healthier You is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.