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.
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!
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.
There are currently two types of tests that provide an early warning system for cervical cancer: a Pap test and an HPV 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.
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 two dose series of HPV vaccine between the ages of 9 and 12. Teens and young adults age 13 through 26 who have not been vaccinated, or who haven’t gotten all their doses, should get the vaccine as soon as possible. HPV vaccines are approved by the U.S. Food and Drug Administration for males and females ages 9 to 45.
- Begin getting Pap tests at age 21. Continue getting Pap tests every 3 years through age 29.
- When you reach age 30, the preferred method of testing is an HPV test along with your Pap test. Get both tests together every 5 years. Screening with the Pap test alone is also an acceptable option.
- Based on new guidance from professional medical organizations, your healthcare provider now has the option to screen you with an HPV test first starting at age 25, followed by additional tests if needed.
Why do the guidelines seem to constantly change? Although it may be frustrating, this is good news! Medical researchers are learning new information practically every day about HPV and its link to cervical cancer. So the experts are continually reviewing new evidence to ensure that the guidelines give healthcare professionals the best and most up-to-date options available.
Note: If your Pap or HPV test ever has unusual results, or if you have had a history of abnormal cells or cervical cancer, your testing schedule may vary.