Cervical cancer can often be prevented or treated early. Indeed, it is estimated that regular screening has reduced cervical cancer deaths by at least 70%.

 Although it is not the most common cancer, it can be deadly. In 2008, nearly 30% of Canadian women diagnosed with cervical cancer died from the disease and about 60% of women that died had not been screened or were inadequately screened (Murphy, 2007).

What is cervical cancer?

Cervical cancer starts in the cells of the cervix. The cervix is the thin passage from the uterus to the vagina. Before cervical cancer develops, the cells of the cervix change and become abnormal. This change is called dyplasia of the cervix. If not treated, dysplasia can develop over time into cancer. However, most women with dysplasia do not develop cancer.

What causes cervical cancer?

The human papilloma virus (HPV) is estimated to cause almost 100% of cervical cancer cases and 90% of all anal cancers. HPV is responsible for the cells in the cervix changing and becoming abnormal (Walboomers et al., 1999).

Other risk factors for developing cervical cancer include:

• Family history.
• Becoming sexually active at a young age.
• Having many sexual partners, or having a sexual partner that has had many sexual partners.
• Smoking.
• Long-term use of birth control pills.
• A weakened immune system.

What is HPV?

There are many different types of HPV. Genital HPV is one of the most common sexually transmitted infections that affect both females and males. It is estimated that 75% of Canadians will have at least one HPV infection during their lifetime (Society of Obstetricians and Gynaecologists of Canada, 2007). People who have HPV may not show any signs or symptoms.

What should you do?

There are three commonly accepted ways to lower the risk for cervical cancer and to detect it early.

1. Limit sexual partners It is important to limit sexual partners and to always use a condom to protect against HPV.
2. Get vaccinated against HPV A new vaccine called Gardasil™ is 100% effective in preventing the four most common kinds of HPV infection. The vaccination has been approved for girls and women aged 9 to 26. Many provinces are funding school-based vaccination programs for teens. Talk to your health care provider about the vaccine.
3. Have routine Pap tests Routine Pap tests are the most important way to detect cervical cancer early. Current Canadian guidelines suggest:

• An initial Pap test within three years of when you begin having sex or at age 21, whichever comes first.

• When Pap tests are normal for 3 years in a row, you may only need a Pap test every 1-3 years until the age of 70.

Take action against cervical cancer

Currently only 72% of eligible Canadian women are routinely screened for cervical cancer. Increased participation in regular screening and greater uptake of the HPV vaccine could reduce the number of Canadian women who die early from this disease. You are in charge of your own health – make sure you get screened and encourage the young women in your life to get the HPV vaccine.

KEY REFERENCES:

Murphy, J. (2007). Screening for cervical cancer. Journal of Obstetricians and Gynecologists Canada, 29(8), S27 – S36.

Society of Obstetricians and Gynaecologists of Canada (2007). Spread the word: General information on HPV. Retrieved June 7, 2009, from http://www.hpvinfo.ca/hpvinfo/pdf/Quick-Facts-General-Info_e.pdf

Walboomers, J.M., Jacobs, M.V., Manos, M.M., Bosch, F.X., Kummer, J.A., Shah, K.V., et al. (1999). Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. Journal of Pathology, 189 (1), 12-19.