January is Cervical Health Awareness Month and it’s a great time for us to review our cervical health as women, including our cervical cancer screening status and HPV vaccination status.
Each year, more than 12,000 women are diagnosed with cervical cancer and more than 4,000 women die from this diagnosis. But over 90% of these cases are preventable with vaccination and appropriate screening as they are caused by certain strains of the human papilloma virus (HPV). There are more than 200 types of HPV that affect humans, however many of them cause common skin warts and genital warts. The few strains that cause cancers can cause cervical, vulvar and vaginal cancers in women, as well as penile cancer in men. Certain anal and oropharyngeal cancers in both men and women are also caused by HPV infection.
The HPV vaccine offers the most protection to individuals who have not been exposed to HPV, but even those who may have been exposed could benefit from immunization. It is recommended that adolescents (both boys and girls) are vaccinated against HPV starting at age 11, although in certain populations, vaccine administration can start as early as age 9. The HPV vaccine is currently approved through age 45.
Screening recommendations for cervical cancer are based on age and risk. The current guidelines recommend that women ages 21 to 29 who are of average risk should be screened with a pap smear every three years if their results are normal. (More frequent screening does not provide more protection, so it’s not recommended.) Women ages 30 to 65 who are of average risk should either continue screening every three years or add HPV testing in addition to the pap smear, which can be done every five years if the results are normal.
Some patients should be screened more frequently as they are at a higher risk for developing cervical cancer. These patients can include those with a history of HIV or immunosuppression.
Most average risk women will complete cervical cancer screening at age 65, but the decision should be discussed with their physician to consider all personal health and risk factors.
Bridget Gruender, MD, MS, DABOM, is a board certified family medicine physician, diplomat of the American Board of Obesity Medicine and physician/owner at Liberty Family Medicine.