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WHAT CAUSES CERVICAL CANCER?

Cervical cells can become abnormal and then if not addressed become cancerous. Also HPV, human papillomavirus, is the leading cause of cervical cancer, and if detected on a PAP smear should be addressed with your gynecologist

 CAN IT BE PREVENTED?

Cervical cancer can be prevented by going to get your annual exam and PAP smears as recommended which can be from every year to every 5 years, depending on the results from the test and what your doctor recommends. Cervical cancer, which is caused by the human papillomavirus (HPV), can also be prevented by the HPV vaccine, which is offered to young people.

WHY ARE CERVICAL CANCER DEATH RATES HIGHER AMONG BLACK WOMEN?

Cervical cancer deaths are higher among Black women and especially older Black women. Studies were corrected for those women who had a hysterectomy, which is usually with removal of the cervix, showiing a significant jump in numbers of deaths.

There are no clear answers why older and Black women are dying of cervical cancer at higher rates. Were they not properly screened? Was there no follow-up after an abnormal screening test? Was something missed during screening? Was treatment ineffective? Answering these questions are critical to identifying the most appropriate interventions that would lower these mortality rates.

 DO YOU RECOMMEND THE HPV VACCINE FOR TEENAGERS WHO ARE NOT SEXUALLY ACTIVE?

As it is hard to dictate when a teenager is going to become sexually active, it is best to be preventative. A full discussion should be had with a pediatrician, gynecologist or family practice doctor on the HPV vaccine, what it is and how it is given. Routine vaccination at age 11-12 for both boys and girls is recommended.

A series of three shots is recommended over six months. HPV vaccination is also recommended for older teens and young adults who were not vaccinated when younger. The reason it is so important is that HPV causes more than 70 percent of all cervical cancer cases, and also increases the risk of vulva, penile, anal, and throat cancers.

HOW OFTEN SHOULD WOMEN HAVE A PAP SMEAR?

PAP smear screening should begin at the age of 21 and includes the Pap test and, for some women, an HPV test.

For a Pap test, the sample is examined to see if abnormal cells are present. For an HPV test, the sample is tested for the presence of 13–14 of the most common high-risk HPV types.

For women aged 21–29 years should have a Pap test alone every 3 years. HPV testing is not recommended.

Women aged 30–65 years should have a Pap test and an HPV test (co-testing) every 5 years (preferred). It also is acceptable to have a Pap test alone every 3 years.

Dr. Shepherd answers your ‘Text Tom’ questions below:

Was HPV around in the 70’s? 

HPV has been around for decades, we just now know it is the leading cause of cervical cancer.

Since HPV is considered a STD, is there a preventive measure for men? Boys can also get the vaccine starting at ages 11-12 so prevention is key

Does HPV affect a person like other STDs? Or is it only suspected to lead to cervical cancer?

It is not like other STD’s where you may have a discharge or lesions. It is a virus that is detected on a test and then your doctor can help you decide how to manage it. It also can cause anal, rectal and oral cancers.

HPV is passed on through genital contact—most often during vaginal and anal sex. HPV may also be passed on during oral sex. Since HPV usually causes no symptoms, most men and women can get HPV— and pass it on—without realizing it. People can have HPV even if years have passed since they had sex. Even men with only one lifetime sex partner can get HPV. 

Is there a test for men?  

Currently, there is no HPV test recommended for men. The only approved HPV tests on the market are for screening women for cervical cancer.  

How much does the screening cost?

Screening should be covered with your annual exam with the PAP smear

Can a woman who has had a hysterectomy still get HPV?

HPV can be detected in the vagina as well however the risk of vaginal cancer is very rare.

My daughter is 13 and has a cycle. When should I take her to get screened/tested for cervical cancer?

PAP smears do not start until the age of 21 however you can take your daughter to get the HPV vaccine which is 3 shots over the course of 6 months.

 I’ve had a hysterectomy. Do I need to still have Pap smears?

If you still have your cervix (confirm with your GYN if you do or not) then you still need Pap smears up until the age of 65 when screening ends however if you had a hysterectomy and do not have a cervix, you do not need a Pap smear any longer.  If the hysterectomy was done because of a cervical abnormality or cervical cancer, then you will need to continue with Pap smears.  Make sure to ask your doctor at your next visit.

Does the herpes simplex virus (HSV) cause cervical cancer, too?

No, HSV is a STD that causes lesions on the mouth or genital area and does not lead to cervical cancer

Should a woman still go for an annual exam if she still has her ovaries?

Absolutely!  The annual exam is not only for a Pap but also for breast exams, screening tests for thyroid, diabetes and hypertension.  It is also a way to make sure you are in your best health.  Good question!

Can a man catch HPV FROM a woman? 

Yes, it can be transmitted either from male to female or vice versa, however most times it is transmitted from male to female.

Is there a cure for HPV? 

There is no cure for HPV as it is a virus and there are no cures for viruses however there are ways to manage it.

Is early menopause a sign of cervical cancer?

No. Menopause is due to the ovaries not secreting estrogen anymore.

How does HPV affect men?

Most men who get HPV (of any type) never develop any symptoms or health problems. But some types of HPV can cause genital warts. Other types can cause cancers of the penis, anus, or oropharynx (back of the throat, including base of the tongue and tonsils.) The types of HPV that can cause genital warts are not the same as the types that can cause cancer. 

Since HPV is a sexually transmitted disease, how does it affect the men who have sex with women that are infected?

Genital human papillomavirus (HPV) is a common virus. Most sexually active people in the United States (U.S.) will have HPV at some time in their lives. There are more than 40 types of HPV that are passed on through sexual contact. These types can infect the genital areas of men, including the skin on and around the penis or anus. They can also infect the mouth and throat.

HPV is passed on through genital contact—most often during vaginal and anal sex. HPV may also be passed on during oral sex. Since HPV usually causes no symptoms, most men and women can get HPV— and pass it on—without realizing it. People can have HPV even if years have passed since they had sex. Even those with only one lifetime sex partner can get HPV. 

If a guy has HPV, how would he know? 

 He would not know as there is no testing for the virus and also there are usually no signs or symptoms.  Prevention is key and also following up with your doctor if it is detected.

How does having fibroids impact the likelihood of getting cervical cancer?

Fibroids is a condition that affects the uterus and therefore will not increase your risk of cervical cancer.

Have have their been research studies to determine the impact of the HPV vaccine? Is there a possibility that the vaccine can progress from 3 injections to 1 injection?

Yes, the studies recently have shown a significant reduction in HPV caused cervical and anal cancers.  They are always working on ways to reduce the amount of injections, however researchers have not achieved success as of yet.

I am scheduled to get a biopsy for cervical cancer what’s the difference between Hpv16 and 18? 

HPV 16 and 18 are the types of HPV that are the leading causes of cervical cancer, so that is why we encourage these types to be further tested with the colposcopy, which is what you are getting.  There are many types of HPV, 16 and 18 we know cause up to 85% of cervical cancers.

Dr. Shepherd is a gynecologist and founder of the online women’s health forum “Her Viewpoint.” She’s a medical expert on The Today Show, Dr. Oz and CBS News, as well as a contributor to several leading publications including Women’s Day, Women’s Health and Essence.

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