Be aware of cervical cancer risks and precautions

While not as pervasive and common as it once was, cervical cancer remains a threat to many women of varying ages. The American Cancer Society’s most recent estimates for cervical cancer in the United States, based on 2012 statistics, indicate that about 12,170 new cases of invasive cervical cancer will be diagnosed in 2013, and approximately 4,220 women will die from cervical cancer.

Non-invasive cervical cancer occurs about four times more often than invasive cervical cancer, and there’s other good news to report: Cervical cancer was once one of the most common causes of cancer death for American women. Then, between 1955 and 1992, the cervical cancer death rate declined by almost 70 percent due, primarily, to the increased use of the Pap test. This screening procedure can find changes in the cervix before cancer develops. It can also find cervical cancer early — in its most curable stage.

The death rate from cervical cancer continued to decline until 2003. Since then it has remained stable in white women, but has gone down in African American women. In the United States, Hispanic women are most likely to get cervical cancer, followed by African-Americans, Asians and Pacific Islanders, and whites. American Indians and Alaskan natives have the lowest risk of cervical cancer in this country.

Cervical cancer tends to occur in midlife. However, most cases are found in women younger than 50, though it rarely develops in women younger than 20. Many older women do not realize that the risk of developing cervical cancer is still present as they age. More than 20 percent of cases of cervical cancer are found in women over 65. However these cancers rarely occur in women who have been getting regular tests to screen for cervical cancer before they were 65.

Risk factors for cervical cancer

Several risk factors increase your chance of developing cervical cancer. Women without any of these risk factors rarely develop cervical cancer. In thinking about risk factors, it helps to focus on those you can change or avoid…like smoking or human papilloma virus (HPV) infection, rather than those you cannot (such as your age and family history). However, it is still important to know about risk factors that cannot be changed, because it’s even more important for women who have these factors to get regular Pap tests to detect cervical cancer early.

Cervical cancer risk factors include:

Smoking tobacco products: Women who smoke are about twice as likely as non-smokers to get cervical cancer. Smoking exposes the body to many cancer-causing chemicals that affect organs other than the lungs. These harmful substances are absorbed through the lungs and carried in the bloodstream throughout the body. Tobacco by-products have been found in the cervical mucus of women who smoke. Researchers believe that these substances damage the DNA of cervix cells and may contribute to the development of cervical cancer. Smoking also makes the immune system less effective in fighting HPV infections.

Cervical cancer may run in some families. If your mother or sister had cervical cancer, your chances of developing the disease are two to three times higher than if no one in the family had it. Researchers suspect that some instances of this familial tendency are caused by an inherited condition that makes some women less able to fight off HPV infection than others. In other instances, women from the same family as a patient already diagnosed may be more likely to have one or more of the other non-genetic risk factors

Oral contraceptives (birth control pills). There is evidence that taking oral contraceptives (OCs) for a long time increases the risk of cancer of the cervix. Research suggests that the risk of cervical cancer goes up the longer a woman takes OCs, but the risk goes back down again after the OCs are stopped. In one study, the risk of cervical cancer was doubled in women who took birth control pills longer than five years, but the risk returned to normal 10 years after they were stopped. The American Cancer Society believes that a woman and her doctor should discuss whether the benefits of using OCs outweigh the potential risks.

HPV infection. The most important risk factor for cervical cancer is infection by the human papilloma virus. HPV is a group of more than 100 related viruses, some of which cause a type of growth called a papilloma, which are more commonly known as warts. HPV can infect cells on the surface of the skin, genitals, anus, mouth and throat, but not the blood or most internal organs such as the heart or lungs. Different types of HPVs cause warts on different parts of the body. These may barely be visible or they may be several inches across. These are considered low-risk types of HPV because they are seldom linked to cancer.

Certain types of HPV are called high-risk types because they are strongly linked to cancers, including cancer of the cervix, vulva, and vagina in women, penile cancer in men, and anal and oral cancer in both men and women. In fact, doctors believe that a woman must be infected by HPV before she develops cervical cancer.  Infection with HPV is common, and in most people the body is able to clear the infection on its own. Sometimes, however, the infection does not go away and becomes chronic. Chronic infection, especially when it is caused by certain high-risk HPV types, can eventually cause certain cancers, such as cervical cancer.

Diet. Overweight women and women with diets low in fruits and vegetables may be at increased risk for cervical cancer.

Chlamydia infection. Chlamydia is a relatively common kind of bacteria that can infect the reproductive system. It is spread by sexual contact. Chlamydia infection can cause pelvic inflammation, leading to infertility. Some studies have seen a higher risk of cervical cancer in women whose blood test results show evidence of past or current chlamydia infection (compared with women who have normal test results). Infection with chlamydia often causes no symptoms in women. A woman may not know that she is infected at all unless she is tested for chlamydia when she gets her pelvic exam.

Regardless of your age and degree of sexual activity, talk with your physician about your cervical health risk factors, or chances of contracting related factors. Regular testing and awareness are the most effective forms of prevention.


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