January marks Cervical Cancer Awareness Month. Cervical cancer is the fourth leading cancer in women—but fortunately, it is both preventable and treatable.

Cervical cancer occurs when cells in the cervix grow abnormally. Most cervical cancer is caused by the human papilloma virus (HPV), a common virus that is passed through sexual contact. For most people, HPV never causes problems, but a prolonged infection can lead to cancers including cervical, anal, and oropharyngeal. Receiving annual well-woman care can help women avoid cervical cancer and improve outcomes for those with a cervical cancer diagnosis.

Understanding Pap smear guidelines

Regular well-woman exams are vital for early detection of cervical cancer. During these visits, your medical provider will perform an exam, talk with you about your health history and menstrual cycle, and address any of your concerns. They may also do a Pap smear, using a small brush to collect cells from your cervix and nearby area to check for abnormalities and HPV.

Currently, the American College of Obstetricians and Gynecologists recommends the following:

1. For ages 21-30, getting Pap smears every three years
2. For ages 30-65, getting Pap smears every five years with co-testing (testing for both cell abnormalities and HPV)

Your medical provider will recommend adjustments to this schedule as appropriate if any test shows abnormalities. After age 65, Pap smears are no longer necessary if your previous results have been normal, but an annual well-woman exam is still important.

Knowing the risk factors

Almost everyone who is sexually active will be exposed to HPV at some point in their lives, but most people with healthy immune systems will clear the virus naturally. Cervical cancer typically develops slowly, usually 10-20 years after the initial HPV infection, but certain risk factors can shorten this timeline. Smoking is a significant risk factor because HPV infections tend to last longer in people who smoke. Other risk factors to be aware of include having multiple sexual partners, inconsistent use of condoms, or having a suppressed immune system resulting from conditions such as an organ transplant, lupus, or untreated HIV.

Cervical cancer often shows no symptoms early on. If you experience vaginal bleeding, unusual discharge, changes in your menstrual cycle, pain during intercourse, or difficulty with urinating or bowel movements, discuss these symptoms with your medical provider. They can be signs of cervical cancer or other health problems that should be addressed.

The HPV vaccine is highly effective in reducing risk

The HPV vaccine protects people against HPV infections. Receiving the vaccine in childhood or young adulthood reduces the risk of developing certain cancers, including cervical cancer. Both boys and girls should receive the HPV vaccine at age 11 or 12, ideally before any exposure to HPV. Those vaccinated before age 15 need two doses, while those starting at 15-26 require three. While the guidelines recommend receiving two or three doses depending on age, promising studies show that receiving even one dose of the HPV vaccine can significantly decrease the risk of developing certain cancers.

For those diagnosed with cervical cancer, treatment options include surgery, chemotherapy, and/or radiation. As with all cancers, early detection leads to better health outcomes. When detected early, the five-year survival rate (the percentage of people who are alive five years after their diagnosis) is 91%, according to the National Cancer Institute.

Annual well-woman exams are important throughout adulthood

Many women may have questions about which exams and tests are necessary, how often they should have Pap smears, and when to see a medical provider. Guidelines change in the medical field as our understanding grows, and this can be confusing for patients. As healthcare providers, we welcome our patients’ questions and want to help clear up any uncertainty.

We also understand that well-woman appointments and pelvic exams can make people feel vulnerable. If you are ever uncomfortable in a medical setting, I encourage you to share your feelings with your provider so you can discuss alternatives for the best way to proceed. A good provider will always make you feel heard. If you don’t feel like you can talk to your provider about this, seek another provider who respects your comfort and will work with you toward your health goals.

Carolyn Wyatt is a women’s health nurse practitioner at MCHC Health Centers, which includes Hillside Health Center and Dora Street Health Center in Ukiah, Little Lake Health Center in Willits, and Lakeview Health Center in Lakeport. MCHC is a community-based and patient-directed organization that provides comprehensive primary healthcare services as well as supportive services such as education and translation that promote access to healthcare.

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