PHILADELPHIA (January 5, 2016) – January is Cervical Health Awareness month, and Fox Chase Cancer Center aims to raise awareness about cervical cancer, risk factors and the importance of screening. According to the Centers for Disease Control and Prevention (CDC), cervical cancer occurs most often in women over age 30. Each year, about 12,000 women in the U.S. get cervical cancer and about 4,000 women die from the disease.
Who is at Risk?
Several risk factors increase a woman’s chance of developing cervical cancer, and women without any risk factors rarely develop the disease. “Simply having a risk factor does not mean you will develop cervical cancer,” said Christina S. Chu, MD, FACOG, surgical oncologist at Fox Chase Cancer Center – Temple Health. “While uncontrollable risk factors exist, women should concentrate on changing or avoiding those factors they can control.”
Human Papillomavirus (HPV) Infection
The most important risk factor for cervical cancer is infection with HPV. This common virus is passed from one person to another through skin-to-skin contact, such as during sex. The CDC notes that at least half of sexually active people will have HPV at some point in their lives, but few women will get cervical cancer. “There are different types, or strains, of HPV and some strains are more strongly linked with certain types of cancers,” Chu said.
Immune System Deficiency
Women with lowered immune systems are at higher risk for developing cervical cancer. This includes women who take drugs to suppress their immune response, such as those being treated for an autoimmune disease, or those who have had an organ transplant. It also includes women with human immunodeficiency virus (HIV), which causes acquired immune deficiency syndrome (AIDS).
Long-Term Use of Oral Contraceptives (Birth Control Pills)
Women who take oral contraceptives for a long time are at increased risk of cervical cancer. Research suggests the risk of cervical cancer increases the longer a woman takes oral contraceptives, but it falls down again after oral contraceptives are stopped. The American Cancer Society (ACS) believes women and their physician should discuss if the benefits of using oral contraceptives outweigh the potential risks.
Smoking
Women who smoke are about twice as likely as non-smokers to develop cervical cancer. Tobacco by-products have been found in the cervical mucus of women who smoke.
Exposure to Diethylstilbestrol (DES)
Women whose mothers were given this drug during pregnancy to prevent miscarriage are at an increased risk of developing a rare type of cancer of the cervix or vagina.
Having Multiple Full-Term Pregnancies
Women who have given birth to three or more children through full-term pregnancies are at an increased risk for cervical cancer. While the reasons are unknown, one theory is these women had unprotected intercourse to get pregnant, so they may have had more exposure to HPV. Studies have also pointed to hormonal changes during pregnancy as possibly making women more susceptible to HPV infection or cancer growth. Another thought is that pregnant women might have weaker immune systems, allowing for HPV infection and cancer growth.
Age of First Full-Term Pregnancy
Women who were younger than 17 years old when they had their first full-term pregnancy are nearly two times more likely to get cervical cancer later in life than those who waited to get pregnant until they were 25 years or older.
Family History
If your mother or sister had cervical cancer, your chances of developing the disease are two to three times higher than if none of your relatives were diagnosed with the disease. Some researchers believe certain instances of this familial tendency are caused by an inherited condition that makes some women less able to fight HPV infection than others. In other cases, women from the same family as a patient already diagnosed could be more likely to have one or more other non-genetic risk factors for cervical cancer.
Screening for Cervical Cancer
“There are two screening tests that can either help prevent cervical cancer, or find it in its earliest stages when the disease is most treatable,” Chu said.
The Pap test, or Pap smear, is one of the most reliable and effective cancer screening tests available. It looks for precancers, or cell changes on the cervix that might become cervical cancer if they are not treated appropriately. The test is recommended for women between 21 and 65 years old.
The human papillomavirus (HPV) test looks for the virus that causes these cell changes and is often given at the time of the Pap test.
“I encourage every woman to speak with her physician to determine what type of testing is right for her,” Chu said.
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