The best way to prevent most cervical cancers is to avoid getting HPV.

And the best way to avoid getting HPV is not to have sex or sexual contact. But we know this is not possible for most people! And this is why we have various tools to help us prevent both HPV and cervical cancer.

HPV Vaccines

There are three HPV vaccines – Cervarix, Gardasil and Gardasil 9) – that can protect against HPV infections.

  • Cervarix protects against HPV 16 and HPV 18 – the two types of HPV that cause approximately 70% of all cervical cancers.
  • Gardasil also protects against HPV 16 and 18, as well as HPV 6 and 11, which are the two types of HPV responsible for 90% of genital warts.
  • Gardasil 9 protects against HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 48, protecting against the types of HPV that cause 90% of genital warts and 90% of HPV-related cancers.

HPV vaccination is the best way to prevent HPV and the cancers it causes. Gardasil 9 is the only vaccine currently available in the US, but if you were vaccinated in another country or before 2014 in the US you may have received Gardasil or Cervarix. Research shows that getting the HPV vaccine in early adolescence dramatically reduces the risk of getting cervical cancer as an adult.

The HPV vaccine is recommended at ages 9-12. If someone missed getting vaccinated by age 12, catch-up vaccination is recommended at ages 13-26. People can still get the HPV vaccine at ages 27-45, but it doesn’t work as well because most people have already been exposed to HPV.

HPV causes over 40,000 cancers in the US each year. These include cancers of the cervix, vagina, vulva, anus, penis, and tongue/tonsils. Vaccination should prevent almost 90% of these cancers.

Just remember, even if vaccinated, women still need to get screened for cervical cancer!

Condoms

If you choose to have sex, have your male partner use condoms. Condoms can help protect against HPV. But since you can get HPV from skin-to-skin contact in the genital area, even people who use condoms can get HPV.

Screening Tests

There are currently two types of tests that provide an early warning system for cervical cancer: a Pap test and an HPV test.

 

Pap test

First, a healthcare provider takes samples of cells from your cervix during your pelvic exam. (Collecting cells from your cervix only takes a few seconds and, though not comfortable, generally isn’t painful at all.)

Next, the cells are sent to a lab where your cervical cells are looked at under a microscope or through an automated magnifying machine to see if there are any abnormal cells. Possible Pap test results are:

  • Normal Pap result: The lab didn’t find any abnormal cells.
  • Unclear or inconclusive Pap result: The cells don’t look clearly abnormal, but they don’t look clearly normal either.
  • Abnormal Pap result: The lab found cell changes. The results are ranked by number of abnormal cells found.
    • CIN 1: mild – about 60% of CIN 1 cases go away on their own
    • CIN 2: moderate
    • CIN 3: severe

Most healthcare providers combine the moderate and severe categories: CIN 2/3.

If you have results that are CIN 2, CIN 3, or CIN 2/3, usually your healthcare provider will directly treat these abnormal cells.

Although the Pap test has helped decrease the number of American women with cervical cancer by about 75% in the past 50 years, newer tests are now needed.

HPV Test

First, a healthcare provider takes samples of cells from your cervix during your pelvic exam. The sample that was taken for the Pap test can be used for the HPV test. An HPV test looks for high-risk HPV that can cause abnormal cells. Some HPV tests can tell you if you have the two types of HPV 16 and HPV 18 – that put you at highest risk for cervical cancer.

If the test finds HPV, you might not have any abnormal cells now. But the HPV could stick around and create abnormal cells in the future. Knowing you have HPV lets your healthcare provider monitor you more closely for cell changes.

Possible results are:

  • Negative HPV result: You do not have HPV. You are at extremely low risk of developing cervical cancer within the next few years.
  • Positive HPV result: You have an HPV type that can potentially lead to cervical cancer. But don’t panic. This does not necessarily mean you have cervical cancer. It means you and your healthcare provider will be keeping a close eye on your cervix.

If you’ve ever had sex with anyone, you need to be tested. Some women think they don’t need to be screened. But they do! This includes women who have been in long-term relationships, lesbians, women who haven’t had sex in many years, and women who’ve only had sex once or with only one partner.

When to Get Vaccinated and/or Screened

Get the HPV vaccine starting at age 9–12 (routine vaccination is recommended at 11–12). Most individuals who begin the series before age 15 need two doses. Teens and young adults through age 26 who have not been vaccinated or did not complete the series should get vaccinated as soon as possible. Adults ages 27–45 may choose to get the vaccine after discussion with their healthcare provider.

Begin cervical cancer screening at age 25 if you have a cervix.

From ages 25–65, choose one of the following screening options:

  • Primary HPV testing every 5 years (preferred),
  • Co-testing (HPV test plus Pap test) every 5 years, or
  • Pap test alone every 3 years.

Screening is not recommended under age 25.

Screening may stop after age 65 if you have had adequate prior screening and are not at high risk.

If you have had a hysterectomy with removal of the cervix, screening is not recommended unless you have a history of high-grade precancer (CIN 2 or CIN 3) or cervical cancer.