Cervical cancer is the third most common gynecologic cancer diagnosis in the United States and the fourth most common cancer diagnosis in women. In the majority of cases, cervical cancer is caused by human papillomavirus, or HPV infection.
"HPV can sometimes lead to cellular changes that can cause cancer," says Miriana Hijaz, M.D., a gynecologic oncologist at Henry Ford Health. "Risk factors for HPV include early onset sexual activity, having multiple sexual partners, having high-risk sexual partners or having a history of sexually transmitted infections (STIs)."
Cervical cancer risk factors that aren’t HPV-related include having a compromised immune system and cigarette smoking, which has been shown to increase squamous cell carcinoma (cancer) of the cervix by approximately 50%. Age is also a risk factor. The median age of cervical cancer diagnosis is 50 years old.
Here, Dr. Hijaz answers common questions about cervical cancer.
If you get an HPV infection that clears when you are young, are you still at risk for developing cervical cancer later in life?
Your risk of developing cervical cancer after having HPV depends upon the length of your HPV exposure, the HPV strain you’re exposed to, and how long it takes your immune system to clear the virus, says Dr. Hijaz. There are high-risk HPV subtypes, for example subtypes 16 and 18, that are mostly associated with HPV-related cervical cancer.
Most people clear the virus within one to two years. It is important to talk to your OB/GYN about how often you should get screened for cervical cancer—even after you clear the virus—as screening is the most important factor for preventing a bad outcome.
What are the screening guidelines for cervical cancer?
According to the American College of Obstetrics and Gynecology, cervical cancer screening should start at age 21 with a Pap smear every three years, which checks for precancerous cells on the cervix. After age 30, options for screening include either a Pap smear every three years, HPV testing every five years, or a co-test, which includes both an HPV test and a Pap smear, every five years.
After age 65, your doctor may say you no longer need to get tested if you’ve had normal screening results for several years or if you’ve had your cervix removed. If you are immunocompromised or if you are at high-risk for cervical cancer, these guidelines change and you should follow the recommendations of your doctor.
What can you do to lower your risk of cervical cancer?
"Cervical cancer screening, as well as HPV vaccination, is essential to lowering your risk of cervical cancer," says Dr. Hijaz. "The HPV vaccine is recommended for children as young as nine years old and can be given to women up to 45 years old. Some people older than age 45 may benefit from vaccination; that’s a conversation to have with your gynecologist. Smoking cessation is also important."
What are the symptoms of cervical cancer?
In the early stages, cervical cancer is usually asymptomatic, meaning there are no symptoms. This underscores the importance of screenings and follow up with your doctor, says Dr. Hijaz. In the later stages, cervical cancer can cause irregular heavy bleeding or postcoital bleeding, among other symptoms.
Cervical Cancer Screening At Henry Ford Health
What are treatment options for cervical cancer?
If caught at an early stage, surgery to remove the tumor is the main treatment option. At more advanced stages, chemotherapy and radiation are necessary. Recently, strides have been made in cervical cancer treatment: targeted therapies and immunotherapy are being used to treat advanced stages of cervical cancer and have been shown to improve outcomes.
What is the five-year survival rate of cervical cancer?
For localized disease—meaning the cancer hasn’t spread to other parts of the body—the survival rate is up to 92%. For regional disease—meaning the cancer has spread to nearby organs—the survival rate is about 58%. For metastatic or distant disease—meaning the cancer has spread to organs far away from the cervix—the survival rate can be as low as 15%.
"The likelihood of recurrence depends upon the stage at which cervical cancer was diagnosed," says Dr. Hijaz. "For more advanced stages, the likelihood of recurrence is higher. For early stages, the likelihood of cure is very high, which is why it's important to communicate with your doctor and maintain your routine healthcare screenings as recommended. As more advances are occurring in cervical cancer treatment, we are more and more able to control the spread of the disease and improve the outcome."
Reviewed by Miriana Hijaz, M.D., a gynecologic oncologist who specializes in ovarian, cervical, vaginal, vulvar and uterine cancers. Dr. Hijaz sees patients at Henry Ford Cancer - Detroit and Henry Ford Medical Center - Lakeside.
