Although not all cervical cancer cases are linked directly to human papillomavirus (HPV) infection, most cervical cancer is caused by HPV infection. HPV infection can cause mutations in the cells of the cervix, leading them to grow excessively. However, HPV is not the sole cause of cervical cancer. Several risk factors can contribute to cervical cancer risk.
Cervical Cancer Rates in 2023
Cervical cancer is currently the 4th most common cancer among women worldwide. Most of these cases (90%) occur in low and middle-income countries. However, cervical cancer rates have decreased dramatically since the recent increase in HPV and cancer screening. In 2023, in the US, there were 13,960 estimated new cases, with 4,310 deaths in January 2023.
Racial and Socioeconomic Disparities
Although overall cervical cancer rates have decreased, several racial and socioeconomic disparities exist. Specifically, according to the American Cancer Society, Hispanic women have the highest incidence of cervical cancer. These disparities are primarily due to a lack of access to screening and healthcare and not due to racial or genetic differences.
What is Cervical Cancer?
Cervical cancer occurs when the cells of the cervix begin to grow uncontrollably. The cervix connects the vagina and the uterus. The cells of the cervix usually will present as pre-cancerous before becoming cancerous. These pre-cancerous cells can be screened for by your doctor and are usually the following:
- Cervical intraepithelial neoplasia (CIN)
- Squamous intraepithelial lesion (SIL)
Types of Cervical Cancer
There are two main classifications of cervical cancers: squamous cell carcinoma and adenocarcinoma. 90% of cervical cancers are squamous cell carincomas; these cancers originate from cells of the exocervix. On the other hand, adenocarincomas develop from glandular cells. Rarely some patients can present with a mixed adenosquamous carcinoma.
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Symptoms of Cervical Cancer
Cervical cancer can be challenging to detect early on as it can often be asymptomatic. However, there are potential symptoms of early-stage cervical cancer to be aware of, especially if you are at high risk.
These early-stage symptoms generally include:
- Vaginal bleeding after sex
- Vaginal bleeding after menopause
- Itching or burning sensations in the vagina
- Bleeding in between periods or having heavier menstrual flows
- Watery vaginal discharge with strong odor
- Blood vaginal discharge
- Pelvic pain
- Pain during intercourse
- Abdominal pain or bloating
If you are experiencing any of these symptoms, it is important to contact your physician and get a proper screening of your cervix to ensure that you are cancer-free.
Risk Factors that Contribute to Increase Risk of Cervical Cancer
There are several risk factors that you can avoid to decrease your risk of cervical cancer. As previously mentioned, HPV infection is a very important risk factor. Long-term HPV infection is linked to cervical cancer and cancers of the vagina, penis, anus, mouth, and throat. Typically, HPV infection tends to resolve itself. Still, when it becomes chronic, it can be a significant risk factor for cervical cancer.
Another risk factor related to HPV is sexual history. Becoming sexually active at a young age or having multiple sexual partners can put you at a higher risk for HPV exposure and infection.
Smoking can also be a risk factor for cervical cancer. According to the American Cancer Society, women who smoke are twice as likely to develop cervical cancer than women who do not smoke. The chemicals and toxins of tobacco smoke can damage cervical cells and lead to cancerous mutations.
HIV is another sexually transmitted infection that can increase the likelihood of cervical cancer. HIV, which can lead to acquired immunodeficiency syndrome (AIDS), can make someone immunocompromised, leading them to be more susceptible to cancer cell development. In fact, women living with HIV are 6 times more likely to develop cervical cancer than women without HIV.
How To Prevent Cervical Cancer
There are a number of interventions that you can pursue to decrease your chances of getting cervical cancer. HPV vaccination is crucial to ensure that you do not get a chronic HPV infection, which can significantly increase your risk of cervical cancer. Regular cervical screenings can also allow your physician to identify any possible precancerous areas and take the appropriate next steps.
HPV Vaccination Recommendations
The HPV vaccine protects against the strains of HPV that cause cervical cancers. According to the CDC, all individuals aged 11 to 12 should be given the HPV vaccine. The youngest age to receive the vaccine is age 9. The vaccine is also recommended for anyone up to 26 years old.
However, the HPV vaccine is not necessarily recommended for individuals older than 26. Although unvaccinated adults aged 27-45 can consider getting the vaccine after discussing the pros/cons with their primary care provider. This is because the HPV vaccine provides less benefit to older individuals as they are more likely to be exposed to HPV. The HPV vaccine only protects individuals from future HPV infections and does not treat pre-existing or ongoing infections.
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HPV Screening Recommendations
There are two main methods of screening for cervical cancer. These screening methods are the Pap test/pap smear or the HPV test. Your gynecologist will perform a Pap smear to look for possible precancers or changes in your cervix. The test will check for any cell changes resulting from an HPV infection. These abnormalities could develop into cervical cancer if not treated.
According to the American Cancer Society, cervical cancer testing should begin at 25. Individuals aged 25 o 65 should receive a primary HPV test. If not, these individuals should have a co-test (HPV test + Pap test) every 5 years.
Although intimidating, a pap smear is a routine and quick procedure essential to cervical cancer prevention. It is recommended that all women aged 21 to 29 should have a pap test performed every 3 years. This procedure typically takes a few minutes. Your doctor will insert a small tool into your vagina so that they can collect a sample of your cervix. This procedure is usually not painful and can be essential in detecting cervical cancer early.
Ultimately, it is essential to understand the fundamental link between HPV and cervical cancer. Although cervical cancer rates are declining, it is important to stay on top of your vaccinations, practice safe intercourse, and obtain routine screenings. Mira is an excellent resource that can help you take control of your health. For an average of $45/month, Mira offers low-cost screenings and consultations to ensure that you take all the necessary precautions for cervical cancer prevention.
Sophie is a 2024 Pharm D. candidate studying pharmacy at Rutgers University, New Brunswick. She has a passion for healthcare and writing and hopes to make meaningful contributions to healthcare transparency and accessibility. In her free time, she likes to take care of her houseplants, cook, and hang out with her cat.