Virginia Commonwealth University

VCU Massey Cancer Center

Preventing cervical cancer

For the first time, a vaccine can actually prevent cervical cancer.

Gardasil™ targets human papillomavirus, or HPV, types 6, 11, 16 and 18, which cause 75 percent of cases of cervical cancer and 90 percent of cases of genital warts. Up to 85 percent of American women are exposed to HPV during their lifetime. HPV has also been associated with vulvar cancer, anal cancer and some head and neck cancers. Gardasil has been approved by the FDA for use in women ages 9 to 27.

Health care providers are beginning to integrate Gardasil into the schedule of other immunizations that children receive during childhood and adolescence.

“The medical community is doing all we can to get the word out,” says Cecelia Boardman, M.D., F.A.C.S., F.A.C.O.G., a gynecologic oncologist at Massey Cancer Center. “Cervical cancer is caused by a virus, HPV. It is a completely preventable disease. In the United States, 10 women die each day due to cervical cancer, and almost 10,000 new cases are diagnosed annually. Through vaccination against HPV and regular Pap smear screening, we now have the potential to eradicate cervical cancer. Continued Pap smear screening is important even in women who have completed their childbearing.”

Remember your Pap tests

According to the American Cancer Society, cervical cancer used to be one of the most common causes of cancer death for U.S. women, but the death rate declined by 74 percent between 1955 and 1992. That was primarily due to an increase in the use of the Pap test, which can detect cellular changes in the cervix before cancer develops.

Cervical cancer tends to occur in midlife, with half of women diagnosed between the ages of 35 and 55. Under current guidelines, all women should begin cervical cancer screening about three years after they begin having vaginal intercourse but no later than age 21. Testing should be done every year with the regular Pap test or every two years using the newer liquid-based Pap test.

Beginning at age 30, most women who have had three normal Pap test results in a row can space out their screenings to every two to three years.

Another option for women over age 30 is to get tested every three years with the regular Pap test or liquid-based Pap test, plus the HPV test.

Most women 70 or older who have had three or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years can choose to stop having the test.

The HPV vaccine

Doctors now believe they are poised to deal cervical cancer an additional blow, thanks to the new HPV vaccine. In the year that has followed its approval, Gardasil has been added to the U.S. Centers for Disease Control and Prevention’s vaccination recommendations for girls ages 11 to 12.

The vaccine, designed for females from ages 9 to 26, requires three shots taken within a six-month period. The second and third doses are given at two and six months after the first dose. Parents should prepare their daughters. The most common side effect is soreness at the injection site.

Keep in mind that girls and women who receive the HPV vaccine will still need regular cervical cancer screening. This is because the vaccine does not protect against all types of HPV that can cause cervical cancer. Also, some women may not receive the full benefit of the vaccine because they may have already been exposed to HPV.

Some women wonder if they or their daughters should get an HPV test or Pap test prior to receiving the vaccine. The answer is no, according to the CDC. Even though an HPV test or Pap test can identify the presence of HPV, it is unable to identify the specific type of HPV. Therefore, even patients with one HPV type can benefit from protection against other types of HPV that the vaccine affords.