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Cervical cancer, the cancer of the lower part of the uterus (womb), is the second-most common cause of female-specific cancer behind breast cancer.

The American Cancer Society estimated that in 2018, about 13,240 new cases of invasive cervical cancer would be diagnosed and about 4,170 women would die from it.

Cervical cancer is also preventable.

Like mammograms and self-breast exams with breast cancer, David Amsbury, DO, an OB/GYN with Trinity Health, said that staying up-to-date with Pap smears and following recommended guidelines is integral to preventing cervical cancer.

“Cervical cancer is something that no woman should have to die from,” Dr. Amsbury said.

Early vaccination, along with regular Pap smears and HPV testing when recommended, is now the best way to prevent cervical cancer, the Foundation for Women’s Cancer said.

The Papanicolaou test, known more commonly as a Pap smear, is a method of cervical screening used to detect potentially pre-cancerous and cancerous processes in the cervix. The Foundation for Women’s Cancer states that since its inception in the 1940s, the Pap smear has reduced deaths from cervical cancer by more than 70 percent.

“It is hoped with wide-spread vaccination and improved screening strategies, fewer and fewer women will be affected by cervical cancer and pre-cancers in the future,” the organization stated on its website. It added that cervical cancer was once one of the most common causes of cancer deaths for American women.

Since 2012, the American Cancer Society recommends that cervical cancers screenings, such as Pap smears, should first be performed at the age of 21 years old. The previous guideline was 18 years of age, but, as Margaret Nordell, MD, and OB/GYN with Trinity Health stated, young women who were still going through the maturation process would be tested and given false positives, leading to unnecessary surgeries.

After the first Pap smear, women are encouraged to get one every three years between the ages of 21 to 29, unless recommended otherwise.

From the ages of 30 to 65, the testing would be done every three years or every five years if combined with HPV testing. From the age of 65, recommendations suggest against screening for those women who are not a high risk for cervical cancer.

“High risk, in general, refers to people who have had a history of abnormal Pap smears or multiple sex partners, as that is how you get exposed to HPV. Those are your two highest risk groups,” Dr. Amsbury said.

He added that if a woman gets the HPV vaccine at a younger age, it is theoretically protecting them from cervical cancer later in life. “You are now vaccinated against those high-risk strains of HPV.”

The vaccination referred to is an HPV vaccine called Gardasil, which is recommended by the Centers for Disease Control and Prevention (CDC), the Advisory Committee on Immunization Practices, and the North Dakota Department of Health. Routine HPV vaccination is recommended or all 11- to 12-year old girls. Catch-up vaccination is also recommended for females ages 13 to 18, and for adults 19 to 26 who were not previously vaccinated.

Amsbury recommends that, if you are a younger person, the Gardasil vaccine should be discussed with a physician.

According to the CDC, risk factors for cervical cancer include smoking, having HIV or another condition that makes it hard for your body to fight off health problems, using birth control pills for a long time (five or more years), having given birth to three or more children, or having several sexual partners.

“HPV virus causes the most of these cervical problems,” Dr. Nordell said. It wasn’t until the 1980s that HPV was identified in cervical cancer tissue, implicating it in virtually all cervical cancers. “We don’t know how the HPV virus is out there, but the way to take care of cervical cancer is to get a Pap smear and treat it accordingly.”

As cervical cancer progresses, symptoms can include vaginal bleeding after intercourse, between periods, or after menopause; watery, bloody vaginal discharge; and pelvic pain or painful intercourse.

Depending on its stage, treatment for cervical cancer can vary.

Trinity Health’s obstetrics and gynecological providers deal with the surgical care of women and their children during pregnancy, childbirth, and the postnatal period. For more information, visit trintiyhealth.org/gynecology.