Ask the Doc: What Is Cervical Cancer and What Is the Connection to HPV?
Cervical cancer is a malignancy that originates in the lower part of the uterus, the part that dilates when you are having a baby. Human papillomavirus (HPV) infection is the primary cause of cervical cancer. Common symptoms of cervical cancer include abnormal bleeding, pelvic pain or discomfort, and pain during sexual activity. HPV infection usually has no symptoms but is picked up on cervical cancer screening.
According to the Centers for Disease Control and Prevention (CDC), cervical cancer occurs most often in people over age 30. When cervical cancer is detected early, it is highly treatable.
In this Q&A, Stephanie V. Blank, MD, Director of Gynecologic Oncology at Mount Sinai Health System, answers frequently asked questions about cervical cancer, including risk factors, its connection to HPV, prevention, and treatment options.
What are the symptoms of cervical cancer?
The main symptom of cervical cancer is abnormal bleeding—spotting that has nothing to do with your period or bleeding after sex.
Are there any risk factors?
Some of the risk factors for cervical cancer include smoking, having multiple sexual partners, and being immunocompromised, which means having a weakened immunity system, such as those who may have advanced or untreated HIV infection.
What is the connection between HPV and cervical cancer?
HPV, which is sexually transmitted, causes most cervical cancer. When somebody gets HPV, many times the body’s immune system makes it go away. But sometimes it persists. When it persists, it can get into cells and cause cells to undergo changes, which eventually can turn into cancer.
Can cervical cancer be prevented?
Cervical cancer can be prevented. We have a wonderful tool to prevent cervical cancer, the HPV vaccine. Getting the HPV vaccine before you ever have sex can prevent cervical cancer. We also have great screening for cervical cancer, which also is a form of prevention. The CDC recommends the HPV vaccination for children 11 to 12 years old.
What screenings are needed for cervical cancer?
Cervical cancer screening now consists of both a Pap smear and HPV testing. In the future, it may consist of HPV testing alone. But when we use these two tests, we screen at different intervals, often depending on age and results of your screening. The important thing about screening is not only to get the screening tests, but also to follow up appropriately.
How often do you need to be screened?
How often you need to be screened depends on your age and the results of your screening test. Most people do not need to be screened every year. You should discuss this with your doctor.
What are the treatment options?
The treatment options for cervical cancer have changed a lot over the past several years. If somebody has cervical cancer and it is early, in many cases they can be treated with a procedure called a cone biopsy that does not remove the whole cervix but just removes the cancer. If somebody has early cervical cancer, it often can be treated with surgery alone. If cancer is more advanced, there may be a need for radiation, or even more advanced chemotherapy or newer drugs.
Why is it important to be treated by a gynecologic oncologist?
With cervical cancer, there are often many different components to care. It is important to be treated by a gynecologic oncologist because you need somebody who understands cervical cancer, who can coordinate this care. It is crucial that a gynecologic oncologist takes on this role for you. Everyone with cancer is different and requires a different treatment plan. At Mount Sinai, we have experienced specialists and a multidisciplinary team who work together to provide the very best care for our patients.