January is Cervical Cancer Awareness Month: Learn How to Protect Your Health

Dr. Bayless Drum, board certified OBGYN at Texas Children’s Pavilion for Women and Assistant Professor at Baylor College of Medicine, writes about cervical health in recognition of cervical cancer awareness month.

January is Cervical Cancer Awareness Month, and it’s a great time to learn about your cervical health and how to protect it. While cervical cancer rates have dropped over the past decades — thanks in large part to cervical cancer screenings and vaccines — the National Cancer Institutes estimates that approximately 14,000 people will be diagnosed with cervical cancer this year and over 4,000 will die from the disease. Below, Dr. Bayless Drum at Texas Children’s Hospital writes about cervical health in order to spread awareness for Cervical Cancer Awareness Month.      

What is your cervix?

Located at the bottom of the uterus, the cervix is a key part of the female reproductive system. The cervix is a small canal that allows fluid to enter and leave the uterus. During childbirth, the cervix widens so that a baby can be born. It plays a pivotal role in menstruation, pregnancy, fertility and childbirth. It also protects the uterus. The cervix is particularly susceptible to HPV infections.

How to prevent cervical cancer?

For the most part, cervical cancer is a preventable disease, and it is most treatable in its early stages. That’s why early detection is so important. The earlier we find it, the better. There are two primary ways you can prevent cervical cancer: by getting the HPV vaccine and by getting your recommended screenings. In both cases, it’s important to talk with your OBGYN about what’s best for you. 

Early detection through screening. 

HPV, or human papillomavirus, is a sexually transmitted infection to which nearly all women are exposed at some point in their lives. HPV is often confused with HSV (herpes simplex virus) or HIV (human immunodeficiency virus), but these are very different infections. HPV can persist in the body without showing any symptoms, so many people will remain unaware of infections. 

When your cervix is infected with certain strains of HPV and your body doesn't naturally fight off that infection, the virus can stay around for a really long time. If the cells in your cervix are exposed to this virus for a prolonged period, those cells can become precancerous. Without treatment, this can eventually lead to cervical cancer, which is why screening tests are so important. When cancer is detected at an early stage, treatment is more effective than at later stages. Even precancerous conditions can be detected and treated when early screenings are performed. 

Screening includes the well-known “Pap smear.” This can detect persistent HPV infection before the cells become cancerous or precancerous. Pap smears used to be performed yearly, but since the addition of HPV testing, Pap smears are now recommended every 3-5 years. It's very unlikely for changes to develop on your cervix within a five-year span that could manifest as cancer. 

To perform a Pap smear, your provider will take a small brush and collect cells from your cervix. These cells are sent for cytology and sometimes for HPV testing. A pathologist looks at the cells underneath a microscope and checks for abnormalities within the cells consistent with evidence of persistent HPV infection. This is because the majority of cervical cancers start with HPV infection.  

The U.S. Preventive Services Task Force (USPSTF) recommends that women get Pap smears every three years when they are 21-29 years old. From 30 to 65, a combination screening is generally recommended: a Pap smear every three years, a high-risk HPV test every five years, or simultaneous testing with both every five years. Testing isn’t recommended for most women over 65 who previously received regular screening.

What to do if your Pap smear result is abnormal?

It is difficult to interpret abnormal Pap smears because the next step will depend on more than just one data point — i.e. what your Pap smear itself shows. Management of your Pap smear results will also depend on your previous pap smear results and medical history which are used to determine your overall risk of developing precancerous cells. 

If you do have an abnormality on your Pap smear, don't panic. Abnormal results do not automatically mean that you have cancer or even precancerous cells — it just means that we need to take the next step to get more information. This is often done with a procedure called a colposcopy. Colpo means cervix and oscopy means to look closely. So, a colposcopy is simply a procedure to look closely at your cervix (using a microscope). This can done in the office. Gynecologists will place a speculum and look at your cervix just like you're getting a pap smear. Sometimes they apply acetic acid, also known as vinegar, to your cervix to help bring out abnormal cells. Then they look at your cervix underneath the microscope. If there are any abnormalities, they will take biopsies of the outside of your cervix and possibly from the lining of your cervical canal. These small pieces of tissue are sent off to a pathologist, who looks at them underneath a microscope and checks for abnormalities consistent with early HPV infection or precancer.  

If there are abnormalities of your cervix consistent with precancer — or something that might lead to precancer if left alone for a prolonged period — then we have a procedure that can be performed to remove the abnormal cells. This is both diagnostic, meaning it confirms that precancer is the full diagnosis, and it's therapeutic. It removes the precancerous cells, often with the margin to cure the precancerous cells so that they cannot stay around and lead to cancer.  

Ask about the HPV vaccine. 

Another layer of protection for your cervical health is the HPV vaccine. Typically, the HPV vaccine is given in two doses to children between the ages of 11 and 14. Teens and young adults can also receive the vaccine (beginning at age 15, however, doctors will recommend three doses). 

Research has shown that the HPV vaccine is highly effective, reducing cancer rates by as much as 40%. In some cases, providers will also recommend the vaccine to adults between the ages of 26 and 45.

Schedule a well-woman checkup. 

Now more than ever, we have incredibly effective preventative treatment options to support your cervical health. Schedule an appointment with a women’s health provider at Texas Children’s Pavilion for Women, call 832-824-9322 or sign into your MyChart to schedule a Well Woman Exam. 

Many experts believe that cervical cancer can be virtually eliminated. During Cervical Cancer Awareness Month, please join our Texas Children’s community in raising awareness and encouraging friends and family members to take the necessary steps to protect their cervical health.

Learn more about Obstetrics and Gynecology services at Texas Children’s Hospital.