How to prevent cervical cancer

Cervical cancer was once a leading cause of cancer death for women in the United States. But rates have decreased greatly in the past 20 years. That’s largely due to improved prevention, including vaccination and regular screening. But cervical cancer remains a problem. There are more than 11,500 new cases of cervical cancer and 4,000 deaths each year in the U.S. Unlike other cancers, cervical cancer primarily affects younger women. It’s most frequently diagnosed in women between the ages of 35 and 44. Cervical cancer rates are highest in Hispanic women, and cervical cancer deaths are highest among Black women. It doesn't have to be this way. "Cervical cancer is a preventable cancer," said Lawrence Lurvey, MD, an ob-gyn with Kaiser Permanente in Southern California. "Our goal is to eliminate cervical cancer among our patients. Our 3-part strategy includes vaccination, screening, and personalized follow-up."

Step 1: Vaccination

In most cases, cervical cancer is caused by the human papillomavirus, known as HPV. There’s a simple way to prevent HPV: get vaccinated. d "HPV-related cancers — which also include throat and rectal cancer in both men and women — are the only type of cancer we currently have a vaccine for," said Lyn Yasumura, MD, an ob-gyn with Kaiser Permanente in Southern California. "That means we could actually eliminate an entire group of diseases." HPV vaccination works best as part of routine childhood vaccinations before any exposure to the virus. "HPV is transmitted through sexual contact, so the best time for someone to get the vaccine is well before they become sexually active," said Dr. Lurvey. "Study after study has shown that vaccinating children does not encourage them to become sexually active — it just protects them when they do." Children should start the HPV vaccine series as early as age 9 and complete it by age 13. Even if you miss that window, the Centers for Disease Control and Prevention recommends the vaccine for young adults up to age 26. And if you’ve screened positive for HPV, the vaccine may still benefit you. It could improve your immune response and help protect against other HPV strains you haven’t been exposed to. The vaccine is approved by the Food and Drug Administration for people up to age 45. So if you’re older than 26, talk to your doctor about whether the vaccine may benefit you.

HPV and cervical cancer

Step 2: Screening

The HPV vaccine provides long-lasting protection, but it doesn’t protect against all types of HPV. And it doesn’t prevent all forms of cervical cancer. Regular screening is essential because it helps detect warning signs before they become a problem. Cervical cancer can usually be treated successfully when it’s found early. For decades, an annual Pap test was the gold standard for cervical cancer screening. But now doctors can use an HPV test alone or together with a Pap. The best test for you depends on your age and your prior test results. "Primary HPV screening can detect HPV long before it causes cancerous changes and it allows you to go up to 5 years between screenings with little additional risk," Dr. Lurvey explained. Because HPV screening is easier to perform than a Pap, convenient and effective at-home cervical cancer screening may be available in the near future. If you’ve had a positive HPV or Pap test result in the past, you may need to be screened more often. Talk to your doctor about how often you should be tested.

Step 3: Personalized follow-up

If your HPV test reveals a viral infection, or if your Pap test comes back as abnormal or unclear, it doesn’t mean you have cancer. But it does mean your care team will work with you to develop a follow-up plan based on national guidelines to help prevent cancer. Follow-up plans are personalized. They provide specific recommendations unique to each patient based on age, previous test results, and other factors. Most HPV infections resolve on their own, so depending on the strain of HPV found, your doctor may recommend repeat screening as the only treatment needed. "When women have access to the care they need, including vaccination and screening, their chances of getting cervical cancer are significantly reduced," Dr. Lurvey said. Learn more about cancer prevention at Kaiser Permanente.