Dr. Hye Sook Chon, a gynecologic oncologist at Moffitt Cancer Center, answers frequently asked questions about cervical cancer.
1. How often should women be screened for cervical cancer?
Here are some guidelines to detect cervical cancer early:
- Cervical cancer screening should begin no earlier than age 21 for women who don’t show any symptoms or have any additional known risk factors. In such women, we suggest screening begin at age 21, regardless of the age they began sexual activity.
- Healthy women who don’t show any symptoms and are under age 30 should begin with pap testing rather than HPV testing (either primary HPV testing or co-testing). Primary HPV screening can be performed in women over age 25 every three years.
- Women ages 30 years and older who do not have known risk factors should be screened with either a Pap test every three years or co-testing (Pap test and HPV testing) every five years if both initial tests are negative.
- In general, we suggest that women ages 65 and older who have had adequate negative prior screening (three consecutive negative Pap tests or two consecutive negative co-tests within the previous 10 years, with the most recent test within the previous five years) not undergo screening for cervical cancer. We continue to offer to screen for cervical cancer to women with a good life expectancy who have risk factors for cervical cancer (a history of an abnormal Pap test, current smoker or history of smoking, unknown prior Pap test history, previous HPV-related disease, or new partners) beyond age 65 years (generally until about age 80, but the upper limit of offering screening may vary with the risk factor).
- We generally screen older women who have not been adequately screened with either Pap test every two to three years or co-testing every five years until age 70 or 75 years.
2. What are some of the symptoms of cervical cancer?
- Irregular or heavy vaginal bleeding
- Bleeding during or after sexual intercourse
- A vaginal discharge that may be watery, thick and/or odorous. Although, this is a nonspecific finding and may be mistaken for infectious causes such as cervicitis.
3. How many HPV strains are cancerous?
Among the more than 40 genital mucosal HPV types identified, approximately 14 are known to be cancerous. Subtypes HPV 16 and 18 are found in over 70 percent of all cervical cancers.
4. When should you see a gynecological oncologist?
If a woman is diagnosed with cervical cancer or if a woman is diagnosed with high-grade cervical dysplasia and interested in fertility preservation, if needed.
5. Are patients who are treated for cervical cancer still able to have children after treatment?
Women can keep their fertility in most of precancerous cervical dysplasia cases. In a defined condition of cervical cancer, fertility preservation treatment is available such as radical trachelectomy.
6. What preventable measures can women take to help lower their risk of getting cervical cancer?
It is easy to reduce the risk of cervical cancer by using screening tests such as a Pap smear and HPV testing. The Pap test takes a sample of cervical cells to determine if any of those cells are abnormal. HPV testing can help determine if any of the high-risk strains of HPV are present, allowing for increased surveillance for cancer if they are. The HPV test detects DNA from 14 high-risk HPV types, including types 16 and 18.
Vaccination: We strongly support vaccination of both girls and boys against HPV to prevent HPV-related cancers. It is estimated that the seven high-risk HPV types found in the most recently approved nonavalent vaccine can potentially prevent over 90 percent of cervical cancers and a similarly high number of other HPV-associated cancers of the vulva, vagina, anus, penis, and some head and neck cancers.